Limits...
A comparison between two methods for tumor localization during totally laparoscopic distal gastrectomy in patients with gastric cancer

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: The aim of this study was to compare two methods of tumor localization during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer.

Methods: From March 2014 to November 2014, patients in whom TLDG had been engaged for middle third gastric cancer enrolled in this study. The patients were allocated to either the radiography or endoscopy group based on the type of tumor localization technique. Clinicopathologic outcomes were compared between the 2 groups.

Results: The accrual was suspended in November 2014 when 39 patients had been enrolled because a failed localization happened in the radiography group. The radiography and endoscopy groups included 17 (43.6 %) and 22 patients (56.4 %), respectively. Mean length of the proximal resection margin did not differ between the radiography and endoscopy groups (4.0 ± 2.6 and 2.8 ± 1.2 cm, respectively; P = 0.077). Mean localization time was longer in the radiography group than in the endoscopy group (22.7 ± 11.4 and 6.9 ± 1.8 minutes, respectively, P < 0.001). There were no statistically significant differences in the incidence of severe complications between the 2 groups (5.9% and 4.5%, respectively, P = 0.851).

Conclusion: As an intraoperative tumor localization for TLDG, radiologic method was unsafe even though other comparable parameters were not different from that of endoscopy group. Moreover, intraoperative endoscopic localization may be advantageous because it is highly accurate and contributes to reducing operation time.

No MeSH data available.


Preoperative endoscopic clipping. Several metal clips were applied in the preoperative endoscopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5016600&req=5

Figure 1: Preoperative endoscopic clipping. Several metal clips were applied in the preoperative endoscopy.

Mentions: The patients were randomized into the radiography and endoscopy groups based on the type of localization technique. The radiography group included the patients who were engaged in radiographic imaging for intraoperative localization of lesions. The endoscopy group included the patients who were engaged in intraoperative endoscopy to localize tumors. In the endoscopy group, an assistant surgeon who was trained in endoscopic procedures performed all intraoperative endoscopic procedures during this period. In both groups, preoperative endoscopic clipping was performed by gastroenterologist. One or 2 metallic clips (HX-600-090L, Olympus, Tokyo, Japan) were applied immediately proximal to the lesion (Fig. 1).


A comparison between two methods for tumor localization during totally laparoscopic distal gastrectomy in patients with gastric cancer
Preoperative endoscopic clipping. Several metal clips were applied in the preoperative endoscopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016600&req=5

Figure 1: Preoperative endoscopic clipping. Several metal clips were applied in the preoperative endoscopy.
Mentions: The patients were randomized into the radiography and endoscopy groups based on the type of localization technique. The radiography group included the patients who were engaged in radiographic imaging for intraoperative localization of lesions. The endoscopy group included the patients who were engaged in intraoperative endoscopy to localize tumors. In the endoscopy group, an assistant surgeon who was trained in endoscopic procedures performed all intraoperative endoscopic procedures during this period. In both groups, preoperative endoscopic clipping was performed by gastroenterologist. One or 2 metallic clips (HX-600-090L, Olympus, Tokyo, Japan) were applied immediately proximal to the lesion (Fig. 1).

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: The aim of this study was to compare two methods of tumor localization during totally laparoscopic distal gastrectomy (TLDG) in patients with gastric cancer.

Methods: From March 2014 to November 2014, patients in whom TLDG had been engaged for middle third gastric cancer enrolled in this study. The patients were allocated to either the radiography or endoscopy group based on the type of tumor localization technique. Clinicopathologic outcomes were compared between the 2 groups.

Results: The accrual was suspended in November 2014 when 39 patients had been enrolled because a failed localization happened in the radiography group. The radiography and endoscopy groups included 17 (43.6 %) and 22 patients (56.4 %), respectively. Mean length of the proximal resection margin did not differ between the radiography and endoscopy groups (4.0 ± 2.6 and 2.8 ± 1.2 cm, respectively; P = 0.077). Mean localization time was longer in the radiography group than in the endoscopy group (22.7 ± 11.4 and 6.9 ± 1.8 minutes, respectively, P < 0.001). There were no statistically significant differences in the incidence of severe complications between the 2 groups (5.9% and 4.5%, respectively, P = 0.851).

Conclusion: As an intraoperative tumor localization for TLDG, radiologic method was unsafe even though other comparable parameters were not different from that of endoscopy group. Moreover, intraoperative endoscopic localization may be advantageous because it is highly accurate and contributes to reducing operation time.

No MeSH data available.