PMID- 36841979
OWN - NLM
STAT- MEDLINE
DCOM- 20230228
LR  - 20230228
IS  - 1565-1088 (Print)
VI  - 25
IP  - 2
DP  - 2023 Feb
TI  - Gastrectomy for Distal Gastric Cancer: Transitioning from an Open to a Minimally 
      Invasive Surgical Practice. A Single Surgeon Experience.
PG  - 110-116
AB  - BACKGROUND: Surgical resection is the only curative option for gastric carcinoma 
      (GC). Minimally invasive techniques are gaining popularity. OBJECTIVES: To 
      present a single-surgeon's experience in transitioning from an open to a 
      minimally invasive approach, focusing on surgical and oncological outcomes. 
      METHODS: We conducted a retrospective analysis including distal gastrectomy 
      patients 2012-2020 operated by a single surgeon. Two cohorts were compared: open 
      (ODG) and laparoscopic distal gastrectomy (LDG). RESULTS: Overall, 173 patients 
      were referred for gastrectomy during the study years. We excluded 80 patients 
      because they presented with non-GC tumors, underwent proximal or total 
      gastrectomy, or underwent palliative surgery. Neoadjuvant treatment was 
      administered to 62 patients (33.3%). Billroth 1 was the preferred method of 
      reconstruction (n=77, 82.8%), followed by Roux-en-Y (n=12, 13%). Fifty-one 
      patients (54.8%) underwent LDG, 42 (45.2%) underwent ODG. The LDG group had 
      significantly shorter lengths of stay (6 days, interquartile range [IQR] 1-3 5-8 
      vs. 5 days, IQR 1-3 4-6, P = 0.001, respectively), earlier return to oral feeding 
      (1 day, IQR 1-3 1-3 vs. 2 days, IQR 1-3 1-3.2, P < 0.001), and earlier removal of 
      drains (4 days, IQR 1-3 3-5.2 vs. 5 days, IQR 1-3 3.5-6.7, P < 0.001). Overall 
      lymph node yield was 30 (IQR 1-3 24-39) and was similar among groups (P = 0.647). 
      CONCLUSIONS: Laparoscopic techniques for resection of distal GC are feasible and 
      safe, leading to good perioperative outcomes and adequate lymph node yield.
FAU - Solomon, Daniel
AU  - Solomon D
AD  - Department of General Surgery, Rabin Medical Center (Beilinson Campus), Petah 
      Tikva, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 
      Israel.
FAU - Greemland, Itzhak
AU  - Greemland I
AD  - Department of General Surgery, Rabin Medical Center (Beilinson Campus), Petah 
      Tikva, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 
      Israel.
FAU - Menasherov, Nikolai
AU  - Menasherov N
AD  - Department of General Surgery, Rabin Medical Center (Beilinson Campus), Petah 
      Tikva, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 
      Israel.
FAU - Bard, Vyacheslav
AU  - Bard V
AD  - Department of General Surgery, Rabin Medical Center (Beilinson Campus), Petah 
      Tikva, Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 
      Israel.
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
SB  - IM
MH  - Humans
MH  - *Stomach Neoplasms/surgery
MH  - Retrospective Studies
MH  - Lymph Nodes/pathology
MH  - *Surgeons
MH  - Gastrectomy/methods
MH  - *Laparoscopy/methods
MH  - Treatment Outcome
MH  - Postoperative Complications/surgery
EDAT- 2023/02/27 06:00
MHDA- 2023/03/03 06:00
CRDT- 2023/02/26 06:03
PHST- 2023/02/26 06:03 [entrez]
PHST- 2023/02/27 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2023 Feb;25(2):110-116.