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Feasibility and Nutritional Benefits of Laparoscopic Proximal Gastrectomy for Early Gastric Cancer in the Upper Stomach

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

Abstract

Background

Laparoscopic proximal gastrectomy (LPG) has recently been applied for early gastric cancer (EGC) in the upper stomach as a minimally invasive and function-preserving surgery. This study aimed to clarify the feasibility and nutritional benefits of LPG over laparoscopic total gastrectomy (LTG).

Methods

This was a retrospective study of 77 patients with clinical stage I gastric cancer in the upper stomach. Of these patients, 25 underwent LPG, while 52 underwent LTG. Surgical outcomes and postoperative nutritional status such as changes in body weight and blood chemistries were compared between LPG and LTG.

Results

Intraoperative blood loss and C-reactive protein levels at 3 and 7 days after surgery were significantly lower in LPG than in LTG (p = 0.018, 0.036, and 0.042, respectively). No significant differences were observed in postoperative early or late complication rates between LPG and LTG. The incidence of Los Angeles Grade B or more severe reflux esophagitis after LPG was 9.1 %, which was similar to that after LTG (9.3 %). Postoperative changes in body weight at 6 months and 1 and 2 years after surgery were consistently less in LPG than in LTG (p = 0.001, 0.022, and 0.001, respectively). Moreover, postoperative levels of hemoglobin and serum albumin and total lymphocyte count were also higher in LPG than in LTG.

Conclusion

LPG may be a better choice for EGC in the upper stomach than LTG because it has distinct advantages in terms of surgical invasiveness and postoperative nutritional status.

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Disclosure

Toshiyuki Kosuga, Daisuke Ichikawa, Shuhei Komatsu, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, and Eigo Otsuji declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Toshiyuki Kosuga MD, PhD, Daisuke Ichikawa MD, PhD, Shuhei Komatsu MD, PhD, Kazuma Okamoto MD, PhD, Hirotaka Konishi MD, PhD, Atsushi Shiozaki MD, PhD, Hitoshi Fujiwara MD, PhD & Eigo Otsuji MD, PhD

Authors
  1. Toshiyuki Kosuga MD, PhD
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  2. Daisuke Ichikawa MD, PhD
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  3. Shuhei Komatsu MD, PhD
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  4. Kazuma Okamoto MD, PhD
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  5. Hirotaka Konishi MD, PhD
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  6. Atsushi Shiozaki MD, PhD
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  7. Hitoshi Fujiwara MD, PhD
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  8. Eigo Otsuji MD, PhD
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Corresponding author

Correspondence to Daisuke Ichikawa MD, PhD.

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Kosuga, T., Ichikawa, D., Komatsu, S. et al. Feasibility and Nutritional Benefits of Laparoscopic Proximal Gastrectomy for Early Gastric Cancer in the Upper Stomach. Ann Surg Oncol 22 (Suppl 3), 929–935 (2015). https://doi.org/10.1245/s10434-015-4590-4

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  • DOI: https://doi.org/10.1245/s10434-015-4590-4

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