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Randomized Comparison of Surgical Stress and the Nutritional Status Between Laparoscopy-Assisted and Open Distal Gastrectomy for Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy (ODG).

Methods

This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG for stage I gastric cancer during the period between May and December of 2011. All patients received the same perioperative care via fast-track surgery. The level of surgical stress was evaluated based on the white blood cell count and the interleukin-6 (IL-6) level. The nutritional status was measured according to the total body weight, amount of lean body mass, lymphocyte count, and prealbumin level.

Results

Twenty-six patients were randomized to receive ODG (13 patients) or LADG (13 patients). The baseline characteristics and surgical outcomes were similar between the two groups. The median IL-6 level increased from 0.8 to 36.3 pg/dl in the ODG group and from 1.5 to 53.3 pg/dl in the LADG group. The median amount of lean body mass decreased from 48.3 to 46.8 kg in the ODG group and from 46.6 to 46.0 kg in the LADG group. There are no significant differences between two groups.

Conclusions

The level of surgical stress and the nutritional status were found to be similar between the ODG and LADG groups in a randomized comparison using the same perioperative care of fast-track surgery.

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Acknowledgment

The authors thank Dr. Hitoshi Katai, a primary investigator of the JCOG-0912 trial, and Professor Mitsuru Sasako, a representative leader of the Gastric Cancer Treatment Group of JCOG. This work was supported, in part, by the Non-Governmental Organizations Kanagawa Standard Anti-cancer Therapy Support System.

Conflict of interest

Toru Aoyama, Takaki Yoshikawa, Tsutomu Hayashi, Shinichi Hasegawa, Kazuhito Tsuchida, Takanobu Yamada, Haruhiko Cho, Takashi Ogata, Hirohito Fujikawa, Norio Yukawa, Takashi Oshima, Yasushi Rino, and Munetaka Masuda declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan

    Toru Aoyama MD, Takaki Yoshikawa MD, PhD, Haruhiko Cho MD, Takashi Ogata MD, PhD & Hirohito Fujikawa MD

  2. Department of Surgery, Yokohama City University, Yokohama, Japan

    Toru Aoyama MD, Takaki Yoshikawa MD, PhD, Tsutomu Hayashi MD, Shinichi Hasegawa MD, Kazuhito Tsuchida MD, Takanobu Yamada MD, Hirohito Fujikawa MD, Norio Yukawa MD, Takashi Oshima MD, PhD, Yasushi Rino MD & Munetaka Masuda MD, PhD

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  1. Toru Aoyama MD
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  2. Takaki Yoshikawa MD, PhD
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  3. Tsutomu Hayashi MD
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  6. Takanobu Yamada MD
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  8. Takashi Ogata MD, PhD
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  9. Hirohito Fujikawa MD
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  11. Takashi Oshima MD, PhD
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  12. Yasushi Rino MD
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  13. Munetaka Masuda MD, PhD
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Corresponding author

Correspondence to Takaki Yoshikawa MD, PhD.

Additional information

Toru Aoyama and Takaki Yoshikawa contributed equally.

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Aoyama, T., Yoshikawa, T., Hayashi, T. et al. Randomized Comparison of Surgical Stress and the Nutritional Status Between Laparoscopy-Assisted and Open Distal Gastrectomy for Gastric Cancer. Ann Surg Oncol 21, 1983–1990 (2014). https://doi.org/10.1245/s10434-014-3509-9

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  • DOI: https://doi.org/10.1245/s10434-014-3509-9

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