Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma
ObjectiveTo evaluate the safety and clinical effect of tubular esophagogastric anastomosis in laparoscopic radical proximal gastrectomy.MethodsA retrospective analysis was conducted involving 191 patients who underwent laparoscopic radical proximal gastrectomy in the Department of Gastrointestinal S...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1167177/full |
| _version_ | 1797857818654539776 |
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| author | Wei Meng Huang Ya-di Cao Wei-bo Zhao Ru-dong Cheng Ze-wei Jun Ou Yang Yan Ze-peng Chen Chuan-qi Liang Yi-ze Sun Dan-ping Yu Wen-bin |
| author_facet | Wei Meng Huang Ya-di Cao Wei-bo Zhao Ru-dong Cheng Ze-wei Jun Ou Yang Yan Ze-peng Chen Chuan-qi Liang Yi-ze Sun Dan-ping Yu Wen-bin |
| author_sort | Wei Meng |
| collection | DOAJ |
| description | ObjectiveTo evaluate the safety and clinical effect of tubular esophagogastric anastomosis in laparoscopic radical proximal gastrectomy.MethodsA retrospective analysis was conducted involving 191 patients who underwent laparoscopic radical proximal gastrectomy in the Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University from January 2017 to October 2020. Patients were divided into tubular esophagogastric anastomosis group (TG group) and traditional esophagogastric anastomosis group (EG group) according to the digestive tract reconstruction. Their intraoperative conditions, perioperative recovery and postoperative follow-up were compared. Patients were also divided into indocyanine green group and non-indocyanine green group according to whether or not indocyanine green tracer technology was used during the operation. Their intraoperative condition and perioperative recovery were compared and analyzed after propensity score matching.ResultsThe operation was successfully completed in all patients. Compared with the EG group, the TG group had less volume of gastric tube drainage, shorter gastric tube drainage time and proton pump inhibitors application time, and lower reuse rate of proton pump inhibitors. However, the TG group had a higher anastomotic stenosis at three months after surgery, as measured using anastomotic width and dysphagia score. Nevertheless, the incidence of reflux esophagitis and postoperative quality of life score in the TG group were lower compared with the EG group at 1st and 2nd year after surgery. In the indocyanine green analysis, the indocyanine green group had significantly shorter total operation time and lymph node dissection time and less intraoperative blood loss compared with the non-indocyanine green group. However, compared with the non-indocyanine green group, more postoperative lymph nodes were obtained in the indocyanine green group.ConclusionLaparoscopic radical proximal gastrectomy is safe and effective treatment option for upper gastric cancer. Tubular esophagogastric anastomosis has more advantages in restoring postoperative gastrointestinal function and reducing reflux, but it has a higher incidence of postoperative anastomotic stenosis compared with traditional esophagogastrostomy. The application of indocyanine green tracer technique in laparoscopic radical proximal gastrectomy has positive significance. |
| first_indexed | 2024-04-09T21:03:59Z |
| format | Article |
| id | doaj.art-55aba51e07544db78f9a72d04697f4d2 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T21:03:59Z |
| publishDate | 2023-03-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-55aba51e07544db78f9a72d04697f4d22023-03-29T05:12:31ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.11671771167177Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinomaWei Meng0Huang Ya-di1Cao Wei-bo2Zhao Ru-dong3Cheng Ze-wei4Jun Ou Yang5Yan Ze-peng6Chen Chuan-qi7Liang Yi-ze8Sun Dan-ping9Yu Wen-bin10Department of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of General Surgery, Weihai Second Hospital, Weihai, ChinaDepartment of General Surgery, Yangxin Hospital of Traditional Chinese Medicine, Yangxin, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery Qilu Hospital of Shandong University, Jinan, ChinaObjectiveTo evaluate the safety and clinical effect of tubular esophagogastric anastomosis in laparoscopic radical proximal gastrectomy.MethodsA retrospective analysis was conducted involving 191 patients who underwent laparoscopic radical proximal gastrectomy in the Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University from January 2017 to October 2020. Patients were divided into tubular esophagogastric anastomosis group (TG group) and traditional esophagogastric anastomosis group (EG group) according to the digestive tract reconstruction. Their intraoperative conditions, perioperative recovery and postoperative follow-up were compared. Patients were also divided into indocyanine green group and non-indocyanine green group according to whether or not indocyanine green tracer technology was used during the operation. Their intraoperative condition and perioperative recovery were compared and analyzed after propensity score matching.ResultsThe operation was successfully completed in all patients. Compared with the EG group, the TG group had less volume of gastric tube drainage, shorter gastric tube drainage time and proton pump inhibitors application time, and lower reuse rate of proton pump inhibitors. However, the TG group had a higher anastomotic stenosis at three months after surgery, as measured using anastomotic width and dysphagia score. Nevertheless, the incidence of reflux esophagitis and postoperative quality of life score in the TG group were lower compared with the EG group at 1st and 2nd year after surgery. In the indocyanine green analysis, the indocyanine green group had significantly shorter total operation time and lymph node dissection time and less intraoperative blood loss compared with the non-indocyanine green group. However, compared with the non-indocyanine green group, more postoperative lymph nodes were obtained in the indocyanine green group.ConclusionLaparoscopic radical proximal gastrectomy is safe and effective treatment option for upper gastric cancer. Tubular esophagogastric anastomosis has more advantages in restoring postoperative gastrointestinal function and reducing reflux, but it has a higher incidence of postoperative anastomotic stenosis compared with traditional esophagogastrostomy. The application of indocyanine green tracer technique in laparoscopic radical proximal gastrectomy has positive significance.https://www.frontiersin.org/articles/10.3389/fonc.2023.1167177/fullupper gastric carcinomalaparoscopic radical proximal gastrectomytubular esophagogastric anastomosistraditional esophagogastrostomyindocyanine green tracer technique |
| spellingShingle | Wei Meng Huang Ya-di Cao Wei-bo Zhao Ru-dong Cheng Ze-wei Jun Ou Yang Yan Ze-peng Chen Chuan-qi Liang Yi-ze Sun Dan-ping Yu Wen-bin Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma Frontiers in Oncology upper gastric carcinoma laparoscopic radical proximal gastrectomy tubular esophagogastric anastomosis traditional esophagogastrostomy indocyanine green tracer technique |
| title | Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| title_full | Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| title_fullStr | Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| title_full_unstemmed | Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| title_short | Clinical effect and follow-up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| title_sort | clinical effect and follow up of laparoscopic radical proximal gastrectomy for upper gastric carcinoma |
| topic | upper gastric carcinoma laparoscopic radical proximal gastrectomy tubular esophagogastric anastomosis traditional esophagogastrostomy indocyanine green tracer technique |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1167177/full |
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