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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
Comparative Study on the Difference in Functional Outcomes at Discharge between Proximal and Total Gastrectomy
Kazuaki Kuwabara1, Shinya Matsuda, Kiyohide Fushimi
1Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
Case Reports in Gastroenterology
|August 31, 2012
Summary
Proximal gastrectomy (PG) and total gastrectomy (TG) show similar outcomes for upper stomach cancer patients regarding complications and functional status. Patient factors and operating time impact results more than the surgical approach.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Geriatric Medicine
Background:
- Proximal gastrectomy (PG) is often favored over total gastrectomy (TG) for upper stomach cancer.
- Functional outcomes are increasingly important for aging populations undergoing surgery.
- Previous community-based data on functional outcomes comparing PG and TG is lacking.
Observation:
- A retrospective study analyzed 12,508 patients undergoing open gastrectomy (PG, TG, or distal gastrectomy - DG) between 2008-2010, focusing on those surviving ≥15 years.
- Data included patient characteristics, comorbidities, Barthel Index (BI) for functional status, complications, and surgical process metrics.
- Multivariate analyses assessed the impact of PG and TG versus DG on complications and BI deterioration.
Findings:
- Neither PG nor TG was significantly associated with increased complications or functional deterioration compared to DG.
- Patient characteristics, preoperative blood transfusion, and longer operating room time were linked to higher complication rates and worse functional outcomes (BI deterioration).
- Significant differences were observed in patient demographics, care processes, oral intake resumption, operating time, length of stay, and total charges across PG, TG, and DG.
Implications:
- Surgical approach (PG vs. TG) did not independently predict complications or functional decline in long-term survivors.
- Physicians should consider patient-specific factors and optimize operating room efficiency to improve outcomes after gastrectomy.
- This study highlights the need to tailor surgical decisions based on individual patient profiles and the potential benefits of PG within appropriate indications.
