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KMID : 1141820220220020094
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Journal of Gastric Cancer
2022 Volume.22 No. 2 p.94 ~ p.106
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Short-Term Outcomes of Laparoscopic Proximal Gastrectomy With Double-Tract Reconstruction Versus Laparoscopic Total Gastrectomy for Upper Early Gastric Cancer: A KLASS 05 Randomized Clinical Trial
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Hwang Sun-Hwi
Park Do-Joong
Kim Hyung-Ho
Hyung Woo-Jin
Hur Hoon
Yang Han-Kwang
Lee Hyuk-Joon
Kim Hyoung-Il
Kong Seong-Ho
Kim Young-Woo
Lee Han-Hong
Kim Beom-Su
Park Young-Kyu
Lee Young-Joon
Ahn Sang-Hoon
Lee In-Seob
Suh Yun-Suhk
Park Ji-Ho
Ahn So-Yeon
Han Sang-Uk
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Abstract
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Purpose: Laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DTR) is a function-preserving procedure performed for treating upper early gastric cancer (EGC). However, few studies have compared the outcomes of LPG-DTR with those of laparoscopic total gastrectomy (LTG). This study aimed at comparing the short-term outcomes of LPG-DTR between LTG and upper EGC.
Materials and Methods: For upper-third EGC, a multicenter, prospective, randomized trial was performed to compare those who underwent LPG-DTR with those who underwent LTG. Short-term outcomes, including clinicopathologic results, morbidity, mortality, and postoperative courses, were evaluated using a full analysis set based on the intention-to-treat principle and the per-protocol set.
Results: Of the patients, 138 who fulfilled the criteria were randomized to each group. One patient in the LPG-DTR group withdrew consent. Sixty-eight patients underwent LPG-DTR and 69 underwent LTG. The operative time (LPG-DTR=219.4 minutes; LTG=201.8 minutes; P=0.085), estimated blood loss (LPG-DTR=76.0 mL; LTG=66.1 mL; P=0.413), and the morbidity rate (LPG-DTR=23.5%; LTG=17.4%; P=0.373) between the groups were not significantly different. No mortality occurred in either of the study groups. Two weeks post operation, the Visick scores for postprandial symptoms, including reflux symptoms, were not significantly different between the groups (P=0.749). Laboratory findings on postoperative day 5 were not significantly different between the groups.
Conclusions: The short-term outcomes of LPG-DTR for upper EGC were comparable to those of LTG.
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KEYWORD
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Surgery, Treatment, Laparoscopy, Diagnosis
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