Laparoscopy-assisted distal gastrectomy (LADG) has been widely used to treat early gastric cancer (EGC). The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system predicts the risk of fatal pos...Laparoscopy-assisted distal gastrectomy (LADG) has been widely used to treat early gastric cancer (EGC). The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system predicts the risk of fatal postoperative complications by quantifying the patient’s reserve and degree of surgical stress, but there have been a few reports of use of the E-PASS scoring system to assess the risk of mortality following special types of surgical procedures such as LADG. In this study we assessed the feasibility of LADG versus open distal gastrectomy (ODG) by the E-PASS scoring system. The subjects of this study consisted of 69 stage IA gastric cancer patients who underwent LADG (LADG group) and 69 stage IA gastric cancer patients who underwent ODG (ODG group). The mean age of the patients in the LADG group was 68.6 years, which was significantly higher than the mean age of 63.4 years in the ODG group. There were no statistically significant differences between the groups in operation time or preoperative risk score, but there were statistically significant differences in blood loss, surgical stress score, comprehensive risk score, and duration of postoperative hospital stay. We conclude that using the E-PASS scoring system, LADG appreciates a more beneficial procedure for the treatment of EGC than ODG.展开更多
Background: Laparoscopic radical gastrectomy for cancer has significant short- and long-term advantages. The feasibility and safety of laparoscopicdistal gastrectomy for cancer (LADG) is unclear in low to middle incom...Background: Laparoscopic radical gastrectomy for cancer has significant short- and long-term advantages. The feasibility and safety of laparoscopicdistal gastrectomy for cancer (LADG) is unclear in low to middle income countries as resources are limited. Therefore, the aim of this study was to evaluate the safety and feasibility of (LADG) in low to middle income countries;Egypt as an example. Methods: Thirty four Patients with stage I-II cancer at the pylorus and antrum have been enrolled for LADG between 2012 and 2015 with the reuse of single use vascular sealing device has been evaluated. Results: Finally 27 patients had been included in the study and successful LADG has been done for all selected cases. The average operative time was 151 ± 10 minutes. The average estimated blood loss was 73.3 ± 13 ml. No intra-operative complications have been recorded. The average time for post-operative patient ambulation was 9 hours (SD ± 1.8) and for oral fluid intake was 3.5 SD ± 1 days. The average duration of the hospital stay was 9.3 ± 1.2 days. The average number of retrieved lymph nodes was 21.7 ± 3.8 days. All the cases had free surgical margin. The median number of reuse of the vascular sealing device was 3.8 times (3 - 5 times). Conclusion: Laparoscopic distal gastrectomy for cancer could be safe and feasible in developing countries and give similar results for that of developed countries. Safe reuse of single use expensive parts of some instruments for laparoscopy could help in utilization of these advanced surgeries in low to middle income countries. Long term follow up as well as comparative studies with open surgery are required.展开更多
文摘Laparoscopy-assisted distal gastrectomy (LADG) has been widely used to treat early gastric cancer (EGC). The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system predicts the risk of fatal postoperative complications by quantifying the patient’s reserve and degree of surgical stress, but there have been a few reports of use of the E-PASS scoring system to assess the risk of mortality following special types of surgical procedures such as LADG. In this study we assessed the feasibility of LADG versus open distal gastrectomy (ODG) by the E-PASS scoring system. The subjects of this study consisted of 69 stage IA gastric cancer patients who underwent LADG (LADG group) and 69 stage IA gastric cancer patients who underwent ODG (ODG group). The mean age of the patients in the LADG group was 68.6 years, which was significantly higher than the mean age of 63.4 years in the ODG group. There were no statistically significant differences between the groups in operation time or preoperative risk score, but there were statistically significant differences in blood loss, surgical stress score, comprehensive risk score, and duration of postoperative hospital stay. We conclude that using the E-PASS scoring system, LADG appreciates a more beneficial procedure for the treatment of EGC than ODG.
文摘Background: Laparoscopic radical gastrectomy for cancer has significant short- and long-term advantages. The feasibility and safety of laparoscopicdistal gastrectomy for cancer (LADG) is unclear in low to middle income countries as resources are limited. Therefore, the aim of this study was to evaluate the safety and feasibility of (LADG) in low to middle income countries;Egypt as an example. Methods: Thirty four Patients with stage I-II cancer at the pylorus and antrum have been enrolled for LADG between 2012 and 2015 with the reuse of single use vascular sealing device has been evaluated. Results: Finally 27 patients had been included in the study and successful LADG has been done for all selected cases. The average operative time was 151 ± 10 minutes. The average estimated blood loss was 73.3 ± 13 ml. No intra-operative complications have been recorded. The average time for post-operative patient ambulation was 9 hours (SD ± 1.8) and for oral fluid intake was 3.5 SD ± 1 days. The average duration of the hospital stay was 9.3 ± 1.2 days. The average number of retrieved lymph nodes was 21.7 ± 3.8 days. All the cases had free surgical margin. The median number of reuse of the vascular sealing device was 3.8 times (3 - 5 times). Conclusion: Laparoscopic distal gastrectomy for cancer could be safe and feasible in developing countries and give similar results for that of developed countries. Safe reuse of single use expensive parts of some instruments for laparoscopy could help in utilization of these advanced surgeries in low to middle income countries. Long term follow up as well as comparative studies with open surgery are required.
