Mide Kanseri İçin Yapılan Gastrektomide Laparoskopik ve Açık Cerrahinin Erken Sonuçlarının Değerlendirilmesi: Tek Merkez Deneyimi

Year 2022, Volume: 12 Issue: 3, 444 - 448, 30.05.2022

Ertugrul Gazi Alkurt , Doğukan Durak , Veysel Barış Turhan

https://doi.org/10.16899/jcm.1054683

Abstract

Amaç: Bu çalışmamızın amacı tüm yaş gruplarında ve her iki cinsiyette en sık görülen altıncı kanser olan mide kanserinin, laparoskopik ve açık cerrahi erken sonuçlarının karşılaştırılmasıdır.
Gereç ve Yöntemler: Mayıs 2018-Ekim 2021 yılları arasında mide kanseri nedeniyle opere edilen hastalar retrospektif olarak incelendi. Laparoskopik va açık cerrahi yapılan hastaların verileri toplandı ve kısa dönem sonuçları karşılaştırıldı. Normal dağılım belirlemek için Kolmogonov-Smirnov testi, devam eden değerler için ortalama+standart sapma ve medyan(minimum maksimum) kullanıldı. Parametrik ölçümlerde Student-t, non parametrik ölçümlerde mann-whitney-u testi kullanıldı. Katagorik değişkenler için chi-square test kullanıldı.
Bulgular: Çalışmaya dahil edilen 140 hastanın sonuçları incelendi. Laparoskopik cerrahide yoğun bakımda kalma süresi daha az ve çıkarılan lenf nodu sayıları daha fazla olarak bulundu. Hastanede yatış süresi ve postoperatif komplikasyonlar benzerdi. Operasyon süresi laparoskopik cerrahilerde daha uzundu.
Sonuç: Kısa dönem sonuçlarımızı karşılaştırdığımız bu çalışmanın sonuçlarına bakıldığında, laparoskopik gastrik rezeksiyonun deneyimli cerrahlar tarafından uygun merkezlerde güvenle yapılabileceğini öngörebiliriz. Cerrahi deneyim arttıkça safra kesesi, apendektomi, prostatektomi gibi ameliyatlarda altın standart olan laproskopinin ilerleyen dönemlerde gastrik kanser cerrahisinde de altın standart olabileceği kanaatindeyiz.

Keywords

Mide kanseri, laparoskopik cerrahi, erken dönem sonuç

Evaluation of Preliminary Results Of Laparoscopic and Open Surgery in Gastrectomy For Gastric Cancer: Single-Center Experience

Abstract

Aim: This study aims to compare the early results of laparoscopic and open surgery of gastric cancer, which is the sixth most common cancer in all age groups and both genders.
Materials and Methods: Patients who were operated on for gastric cancer between May 2018 and October 2021 were analyzed retrospectively. The data of patients who underwent laparoscopic and open surgery were collected and short-term results were compared. Kolmogorov-Smirnov test was used to determine the normal distribution, mean+standard deviation, and median (minimum-maximum) were used for continuous values. Student-t-test was used for parametric measurements and the Mann-Whitney-u test was used for non-parametric measurements. The chi-square test was used for categorical variables.
Results: The results of 140 patients included in the study were analyzed. In laparoscopic surgery, the length of stay in the intensive care unit was shorter and the number of lymph nodes removed was found to be higher. Length of hospital stay and postoperative complications were similar. The operation time was longer in laparoscopic surgeries.
Conclusion: Considering the results of this study, in which we compared our short-term results, we can predict that laparoscopic gastric resection can be safely performed by experienced surgeons in appropriate centers. As surgical experience increases, we believe that laparoscopy, which is the gold standard in surgeries such as gallbladder, appendectomy, and prostatectomy, may become the gold standard in gastric cancer surgery in the future.

Keywords

Gastric cancer, laparoscopic surgery, preliminary results

References

• Gürsoy D., Seçinti İ. E., Doğan E., Temiz M. Clinicopathologic features and KRAS mutation incidence of gastric carcinomas. J Contemp Med. 2022; 12(1): 1-1.
• Mistry M, Parkin DM, Ahmad AS, Sasieni P. Cancer incidence in the United Kingdom: projections to the year 2030. Br J Cancer. 2011;105:1795–1803.
• Shin A, Kim J, Park S.Gastric cancer epidemiology in Korea. J Gastric Cancer. 2011;11:135–140.
• Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomized nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11:439–449.
• Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 2013;23:480
• Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.
• Kim MC, Kim HH, Jung GJ. Surgical outcome of laparoscopy-assisted gastrectomy with extraperigastric lymph node dissection for gastric cancer. Eur J Surg Oncol. 2005;31:401–405.
• Lu J, Huang CM, Zheng CH, et al. Short- and long-term outcomes after laparoscopic versus open total gastrectomy for elderly gastric cancer patients: a propensity score-matched analysis. J Gastrointest Surg 2015;19:1949–57.
• Chen X, Feng X, Wang M, Yao X. Laparoscopic versus open distal gastrectomy for advanced gastric cancer: A meta-analysis of randomized controlled trials and high-quality nonrandomized comparative studies. Eur J Surg Oncol 2020;46:1998–2010.
• Shan F, Gao C, Li XL, et al. Short and long-term outcomes after laparoscopic versus open gastrectomy for elderly gastric cancer patients: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A 2020;30:713–22.
• Kim W, Kim HH, Han SU, et al. Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group. Decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg 2016;263:28–35.
• Katai H, Mizusawa J, Katayama H, et al. Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/ IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912. Gastric Cancer 2017;20:699–708
• Liu F, Huang C, Xu Z, et al; Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group. Morbidity and mortality of laparoscopic vs open total gastrectomy for clinical stage I gastric cancer: The CLASS02 multicenter randomized clinical trial. JAMA Oncol 2020;6:1590–7.
• Yu J, Huang C, Sun Y, et al; Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group. Effect of laparoscopic vs open distal gastrectomy on 3-year disease-free survival in patients with locally advanced gastric cancer: The CLASS-01 randomized clinical trial. JAMA 2019;321:1983–92.
• Li B, Yu-Hong Wong I, Siu-Yin Chan F, et al. Comparison of laparoscopic versus open gastrectomy for gastric cancer. Surg Oncol 2020;35:14–21.
• Lee HJ, Hyung WJ, Yang HK, et al; Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group. Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT). Ann Surg 2019;270:983–91.
• Kim HH, Han SU, Kim MC, et al. Long-term results of laparoscopic gastrectomy for gastric cancer: a large-scale case-control and case-matched Korean multicenter study. J Clin Oncol 2014;32:627–33.
• Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101–12
• Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205–13.
• Memon MA, Khan S, Yunus RM, Barr R, Memon B. Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma. Surg Endosc. 2008;22(8):1781-1789.
• Liu F, Huang C, Xu Z, et al. Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer: The CLASS02 Multicenter Randomized Clinical Trial. JAMA Oncol. 2020;6(10):1590–1597.
• Zeng F, Chen L, Liao M, et al. Laparoscopic versus open gastrectomy for gastric cancer. World J Surg Onc. 2020;18(1):1-12.
• Erbella J Jr, Bunch GM. Single-incision laparoscopic cholecystectomy: the first 100 outpatients. Surg Endosc. 2010;24(8):1958-61.
• Kössler-Ebs JB, Grummich K, Jensen K. et al. Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis. World J Surg. 2016;40, 2319–30.