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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment

Published on: December 27, 2024

A Path to High-Value Gastric Cancer Surgery Care Delivery.

Swee H Teh¹, Sharon Shiraga¹, Aaron M Kellem²

¹From the The Permanente Medical Group, Gastric Cancer Surgery, Northern California, CA.

Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches

|June 24, 2024

Summary

Implementing a comprehensive regional program, including the Minimally Invasive Recovery and Empowerment Care (MIREC) pathway, significantly reduced hospital stays and adverse events for laparoscopic gastrectomy patients. This approach enhances gastric cancer surgery outcomes and patient value.

Keywords:

adjuvant therapy gastric cancer laparoscopic gastrectomy length of stay postoperative recovery return to care surgery

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Published on: August 9, 2016

Area of Science:

Oncology
Surgical Innovation
Healthcare Management

Background:

Cost-effectiveness and improved patient outcomes are paramount in global gastric cancer care.
Optimizing surgical pathways is essential for enhancing the quality of care for gastric cancer patients.

Purpose of the Study:

To assess the feasibility, safety, and effectiveness of a comprehensive regional program for gastric cancer surgery.
To evaluate the impact of the Minimally Invasive Recovery and Empowerment Care (MIREC) pathway on reducing hospital stays post-laparoscopic gastrectomy.

Main Methods:

A comparative study analyzed outcomes of gastric cancer surgery between pre-MIREC and post-MIREC implementation periods (February 2012-March 2023).
Primary endpoint: length of hospital stay. Secondary endpoints: intensive care unit (ICU) utilization, emergency room (ER) visits, readmission, reoperation, and 30-day mortality.
Data included perioperative chemotherapy and laparoscopic gastrectomy rates.

Main Results:

Hospitalization decreased from 7 to 2 days post-MIREC implementation (P < 0.0001), with 88% discharged by postoperative day 2.
Significant reductions observed in ICU utilization (10.8% vs. 2.9%), ER visits (34.7% vs. 19.7%), and 30-day readmissions (18.6% vs. 11.1%) (P < 0.0001).
Laparoscopic gastrectomy rates increased from 17.4% to 97.7%, and perioperative chemotherapy use rose significantly.

Conclusions:

A comprehensive regional program, integrating MIREC, improved gastric cancer surgery outcomes, including reduced hospital stays and complications.
This integrated approach, encompassing regionalization, minimally invasive surgery, and modern oncologic care, enhances patient value and quality of care.
The MIREC pathway demonstrates potential to revolutionize gastric cancer surgical delivery.