Abstract
To clarify whether gastric cancer patients can benefit from laparoscopy-assisted surgery completed by junior surgeons under supervision of expert surgeons, data of 232 patients with gastric cancer underwent operation performed by inexperienced junior surgeons were reviewed. Of the 232 patients, 137 underwent laparoscopy- assisted resection and in 118 cases this approach was successful. All of these 118 patients were assigned to laparoscopic group in this study, 19 patients who were switched to open resection were excluded. All laparoscopic operations were performed under the supervision of expert laparoscopic surgeons. Some 95 patients receiving open resection were assigned to the open group. All open operations were completed independently by the same surgeons. Short-term outcomes including oncologic outcomes, operative time intra-operative blood loss, time to first flatus, time to first defecation, postoperative hospital stay and perioperative complication were compared between the two groups. The numbers of lymph nodes harvested in the laparoscopic and open groups were21.1±9.6 and 18.2±9.7 (p=0.029). There was no significant difference in the length of margins. The mean operative time was 215.9±32.2 min in laparoscopic group and 220.1±34.6min in the open group (p=0.866), and the mean blood loss in laparoscopic group was obviously less than that in open group (200.9±197.0ml vs 291.1±191.4ml; p=0.001). Time to first flatus in laparoscopic and open groups was 4.0±1.0 days and 4.3±1.2days respectively and the difference was not significant (p=0.135). Similarly no statically significant difference was noted for time to first defecation (4.7±1.6 vs 4.8±1.6, p=0.586). Eleven patients in the laparoscopic group and 19 in the open group suffered from peri-operative complications and the difference between the two groups was significant (9.3% vs 20.0%, p=0.026). The conversion rate for laparoscopic surgery was 13.9%. Patients with gastric cancer can benefit from laparoscopy-assisted operations completed by inexperienced junior surgeons under supervision of expert laparoscopic surgeons.
Highlights
Health and life of Asian is threatened by gastric cancer seriously (Atrkar-Roushan et al, 2013; Unal et al, 2014)
Whether every surgeon can perform this approach perfectly? Whether laparoscopic operation performed by inexperienced junior surgeons can get satisfactory results? Aimed at finding answers for these questions, a study was designed by us to compare the different outcomes of laparoscopy-assisted gastric cancer resection performed by inexperienced junior surgeons under the supervision of expert laparoscopic surgeons and open resection completed by the same surgeons
A total of 137 patients were attempted to deliver laparoscopy-assisted gastric cancer resection. 118 patients underwent this approach successfully were assigned to laparoscopic group. 19 patients were converted to open surgery and they were excluded from analysis. 95 patients underwent open surgery were assigned to open group
Summary
Health and life of Asian is threatened by gastric cancer seriously (Atrkar-Roushan et al, 2013; Unal et al, 2014). Technique of laparoscopy-assisted gastric cancer resection was reported by Kitano et al in 1994 firstly (Kitano et al, 1994). This technique has been accepted by surgeons and patients gradually and the advantages of this approach have been confirmed by several centers (Kim et al, 2012; Shinohara et al, 2013; Sakuramoto et al, 2013; Haverkamp et al, 2013; Liao et al, 2013). Aimed at finding answers for these questions, a study was designed by us to compare the different outcomes of laparoscopy-assisted gastric cancer resection performed by inexperienced junior surgeons under the supervision of expert laparoscopic surgeons and open resection completed by the same surgeons Whether every surgeon can perform this approach perfectly? Whether laparoscopic operation performed by inexperienced junior surgeons can get satisfactory results? Aimed at finding answers for these questions, a study was designed by us to compare the different outcomes of laparoscopy-assisted gastric cancer resection performed by inexperienced junior surgeons under the supervision of expert laparoscopic surgeons and open resection completed by the same surgeons
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