Clinical efficacy of three-dimensional laparoscopic resection for gastric stump cancer

Abstract

Objective To investigate the clinical efficacy of three-dimensional (3D) laparoscopic resection for gastric stump cancer. Methods The retrospective cross-sectional study was conducted. The clinicopathological data of 20 patients who underwent 3D laparoscopic resection for gastric stump cancer in the Henan Provincial People′s Hospital between January 2015 and January 2018 were collected. All patients were diagnosed as malignant tumors through gastroscopy and pathological examination before operation, and underwent 3D laparoscopic resection for gastric stump cancer and lymph node dissection according to Japanese Classification of Gastric Carcinoma (ver. 14). Observation indicators: (1) intra- and post-operative recovery situations; (2) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival and tumor recurrence up to March 2018. Measurement data with normal distribution were represented as ±s. Measurement data with skewed distribution were described as M (range). Results (1) Intra- and post-operative recovery situations: of 20 patients with gastric stump cancer, 14 underwent 3D laparoscopic radical resection for gastric stump cancer (R0 resection and negative resection margin), 4 underwent 3D laparoscopic palliative resection for gastric stump cancer and 2 were converted to open palliative resection for gastric stump cancer. Operation time, volume of intraoperative blood loss, number of lymph node dissected, time for postoperative out-of-bed activity, time to initial anal exsufflation, time for postoperative semi-fluid diet intake, duration of hospital stay and treatment expenses in 18 patients were (195±60)minutes, (105±85)mL, 20±8, (1.6±0.8)days, (3.0±1.0)days, (5.5±1.8)days, (8.0±2.8)days and (5.5±1.5)×104 yuan, respectively. There was no surgery-related complication. (2) Follow-up and survival situations: of 20 patients, 18 were followed up for 2-36 months, with a median time of 18 months. During the follow-up, 6 patients died, including 2 dying of liver metastases and 4 dying of peritoneal metastases, 12 had good conditions. Conclusion 3D laparoscopic resection for gastric stump cancer is safe and effective. Key words: Gastric neoplasms; Gastric stump neoplasms; Surgical complications; Efficacy; Three-dimension; Laparoscopy