Hand-Assisted Laparoscopic <i>Versus</i> Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LUOGuo-de , CAOYong-kuan , ZHANGLin , ZHANGGuo-hu , WANGPei-hong , GONGJia-qing

Gastrointestinal Ward of PLA General Surgery Centre, Chengdu Army General Hospital, Chengdu 610083, Sichuan Province, China;

Corresponding author：

LUOGuo-de, Email: deguoluo@126.com

Keywords：

Hand-assisted laparoscope; Open surgery; Remnant gastric cancer; Radical gastrectomy

DOI：

10.7507/1007-9424.20160347

Video：

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Objective To explore feasibility and advantages of hand-assisted laparoscopic radical resection for remnant gastric cancer. Methods The clinical data of 26 patients with remnant gastric cancer who underwent hand-assisted laparoscopic (hand-assisted group, n=13) or open (open group, n=13) radical resection from December 2007 to May 2016 in this hospital were retrospectively analyzed. The perioperative outcomes were compared between these two groups. Results There was no conversion to open surgery in the hand-assisted group. Compared with the open group, the incision length was significantly reduced (P=0.000), the intraoperative blood loss was significantly decreased (P=0.038), postoperative the first anal exhaust time was significantly shortened (P=0.025) in the hand-assisted group. The operation time, the number of lymph nodes dissection, and the incidence of postoperative complications had no statistically significant differences between these two groups (P>0.05). Conclusion The preliminary results of limited cases in this study show that hand-assisted laparoscopic radical resection for remnant gastric cancer is safe and feasible, it has several advantages including small incisions, mild intraoperative hemorrhage, rapid postoperative recovery, better recent clinical therapeutic outcome and so on as compared with open surgery.

Citation： LUOGuo-de, CAOYong-kuan, ZHANGLin, ZHANGGuo-hu, WANGPei-hong, GONGJia-qing. Hand-Assisted Laparoscopic Versus Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1358-1361. doi: 10.7507/1007-9424.20160347 Copy

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2.	秦新裕, 刘凤林. 重视残胃癌的诊断和治疗. 中国实用外科杂志, 2009, 29(10):798-799.
3.	戴冬秋. 早期残胃癌的临床病理特点与合理治疗. 中国实用外科杂志, 2009, 29(10):800-802.
4.	Shinohara T, Hanyu N, Tanaka Y, et al. Totally laparoscopic comp-lete resection of the remnant stomach for gastric cancer. Langenbecks Arch Surg, 2013, 398(2):341-345.
5.	武爱文, 季加孚. 残胃癌诊断与微创治疗应用现状. 中华胃肠外科杂志, 2013, 16(2):132-134.
6.	曹永宽, 周均, 刘立业, 等. 手辅助腹腔镜与腹腔镜辅助胃癌D2根治术的临床对照研究. 中国普外基础与临床杂志, 2012, 19(11):1208-1212.
7.	张斌. 残胃癌的临床诊治分析. 中国实用医药, 2012, 3(7):82-83.
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9.	Mezhir JJ, Gonen M, Ammori JB, et al. Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease. Ann Surg Oncol, 2011, 18(3):670-676.
10.	陈金元. 不同术式治疗残胃癌患者的预后及相关影响因素分析. 局解手术学杂志, 2014, 23(2):189-190.
11.	Sasaki K, Fujiwara Y, Kishi K, et al. Pathological findings of gastric mucosa in patients with gastric remnant cancer. Hepatogastroentero-logy, 2014, 61(129):251-254.
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13.	Hosokawa Y, Konishi M, Sahara Y, et al. Limited subtotal gastrec-tomy for early remnant gastric cancer. Gastric Cancer, 2014, 17(2):332-336.
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16.	Nozaki I, Hato S, Kurita A. A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition. Surg Today, 2012, 42(11):1135-1138.
17.	Komatsu S, Ichikawa D, Okamoto K, et al. Differences of the lymp-hatic distribution and surgical outcomes between remnant gastric cancers and primary proximal gastric cancers. J Gastrointest Surg, 2012, 16(3):503-508.
18.	Meyer F, Benedix F, Garlipp B, et al. Gastric stump carcinoma-a surgical and oncological challenge. Z Gastroenterol, 2011, 49(9):1270-1275.
19.	邓洪强, 吴鸿根, 刘超. 残胃癌淋巴结转移的相关研究. 中国普外基础与临床杂志, 2013, 20(5):536-539.
20.	赵冬雨, 成丽娅, 于健. 60例残胃癌的临床特点及外科治疗体会. 中国普外基础与临床杂志, 2014, 21(3):352-354.
21.	王晔, 丁士刚. 残胃癌发病机制及治疗. 癌症进展, 2016, 14(1):4-6.
22.	Nagai E, Nakata K, Ohuchida K, et al. Laparoscopic total gastrectomy for remnant gastric cancer:feasibility study. Surg Endosc, 2014, 28(1):289-296.
23.	曹永宽, 刘立业, 罗国德, 等. 手辅助腹腔镜行胃癌D2根治术的手术安全与技术路径探讨. 中国普通外科杂志, 2012, 21(4):373-376.
24.	Gong J, Cao Y, Wang Y, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.
25.	Gong J, Cao Y, Li Y, et al. Hand-assisted laparoscopic versus laparo-scopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.

1. 钟晓刚, 殷舞, 麦威, 等. 残胃癌外科治疗临床分析及再认识. 中国普外基础与临床杂志, 2012, 19(1):20-24.
2. 秦新裕, 刘凤林. 重视残胃癌的诊断和治疗. 中国实用外科杂志, 2009, 29(10):798-799.
3. 戴冬秋. 早期残胃癌的临床病理特点与合理治疗. 中国实用外科杂志, 2009, 29(10):800-802.
4. Shinohara T, Hanyu N, Tanaka Y, et al. Totally laparoscopic comp-lete resection of the remnant stomach for gastric cancer. Langenbecks Arch Surg, 2013, 398(2):341-345.
5. 武爱文, 季加孚. 残胃癌诊断与微创治疗应用现状. 中华胃肠外科杂志, 2013, 16(2):132-134.
6. 曹永宽, 周均, 刘立业, 等. 手辅助腹腔镜与腹腔镜辅助胃癌D2根治术的临床对照研究. 中国普外基础与临床杂志, 2012, 19(11):1208-1212.
7. 张斌. 残胃癌的临床诊治分析. 中国实用医药, 2012, 3(7):82-83.
8. Komatsu S, Ichikawa D, Okamoto K, et al. Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy. World J Gastroenterol, 2012, 18(22):2832-2836.
9. Mezhir JJ, Gonen M, Ammori JB, et al. Treatment and outcome of patients with gastric remnant cancer after resection for peptic ulcer disease. Ann Surg Oncol, 2011, 18(3):670-676.
10. 陈金元. 不同术式治疗残胃癌患者的预后及相关影响因素分析. 局解手术学杂志, 2014, 23(2):189-190.
11. Sasaki K, Fujiwara Y, Kishi K, et al. Pathological findings of gastric mucosa in patients with gastric remnant cancer. Hepatogastroentero-logy, 2014, 61(129):251-254.
12. Okaniwa A, Murayama I, Watanabe Y, et al. A patient with advanced remnant gastric cancer responding completely to S-1 monotherapy. Gan To Kagaku Ryoho, 2011, 38(7):1191-1195.
13. Hosokawa Y, Konishi M, Sahara Y, et al. Limited subtotal gastrec-tomy for early remnant gastric cancer. Gastric Cancer, 2014, 17(2):332-336.
14. Di Leo A, Pedrazzani C, Bencivenga M, et al. Gastric stump cancer after distal gastrectomy for benign disease:clinicopathological features and surgical outcomes. Ann Surg Oncol, 2014, 21(8):2594-2600.
15. Tokunaga M, Sano T, Ohyama S, et al Clinicopathological charac-teristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg, 2013, 17 (2):313-318.
16. Nozaki I, Hato S, Kurita A. A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition. Surg Today, 2012, 42(11):1135-1138.
17. Komatsu S, Ichikawa D, Okamoto K, et al. Differences of the lymp-hatic distribution and surgical outcomes between remnant gastric cancers and primary proximal gastric cancers. J Gastrointest Surg, 2012, 16(3):503-508.
18. Meyer F, Benedix F, Garlipp B, et al. Gastric stump carcinoma-a surgical and oncological challenge. Z Gastroenterol, 2011, 49(9):1270-1275.
19. 邓洪强, 吴鸿根, 刘超. 残胃癌淋巴结转移的相关研究. 中国普外基础与临床杂志, 2013, 20(5):536-539.
20. 赵冬雨, 成丽娅, 于健. 60例残胃癌的临床特点及外科治疗体会. 中国普外基础与临床杂志, 2014, 21(3):352-354.
21. 王晔, 丁士刚. 残胃癌发病机制及治疗. 癌症进展, 2016, 14(1):4-6.
22. Nagai E, Nakata K, Ohuchida K, et al. Laparoscopic total gastrectomy for remnant gastric cancer:feasibility study. Surg Endosc, 2014, 28(1):289-296.
23. 曹永宽, 刘立业, 罗国德, 等. 手辅助腹腔镜行胃癌D2根治术的手术安全与技术路径探讨. 中国普通外科杂志, 2012, 21(4):373-376.
24. Gong J, Cao Y, Wang Y, et al. Three-step hand-assisted laparoscopic D2 radical gastrectomy for Chinese obese patients:a highly efficient and feasible surgical approach. J Cancer, 2015, 6(2):120-127.
25. Gong J, Cao Y, Li Y, et al. Hand-assisted laparoscopic versus laparo-scopy-assisted D2 radical gastrectomy:a prospective study. Surg Endosc, 2014, 28(10):2998-3006.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Hand-Assisted Laparoscopic Versus Open Radical Resection for Remnant Gastric Cancer: A Comparison of Surgical Therapeutic Outcome

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