Abstract
Laparoscopy-assisted distal gastrectomy (LADG) has become one of the standard surgical procedures for gastric cancer in Japan and Korea. However, LADG is currently listed as being in the clinical research phase under the Gastric Cancer Treatment Guidelines. The aim of this study is to report surgeons’ opinions of what is needed if LADG is to become a standard procedure. We conducted questionnaire survey with open questions in hospitals that either applied or did not apply LADG and compared the answers. We labeled and categorized the collected data using content analysis. The number of hospitals which applied LADG more than doubled from 5 to 12 hospitals over 3 years. Overall, hospitals reported that the necessary elements for LADG to become a standard procedure are: clinical trials of LADG (n = 5, 22.7%), surgeons’ practical experience in performing LADG (n = 4, 18.2%), stability of radical treatment (n = 4, 18.2%), and a shorter operative duration (n = 3, 13.6%) for the procedure. Surgeons’ practical experience was chosen as the most important requirement in the hospitals which applied LADG while clinical trials (n = 2, 40.0%) and stability of radical treatment (n = 2, 40.0%) were the most common answers in the hospitals which did not apply LADG. Hospitals and surgeons’ practical experience, stabilizing radical cure, and the large scale of clinical trials are for LADG to become a standard procedure and to gain equivalent importance as open distal gastrectomy in treating gastric cancer.
Highlights
Laparoscopy-assisted distal gastrectomy (LADG) has garnered interest as a surgical procedure for gastric cancer that is noninvasive and that offers better postoperative outcomes than other available procedures [1]-[4]
In 2012, we asked surgeons at the hospitals which applied LADG and surgeons at the hospitals which did not apply LADG about 1) their standard surgery for gastric cancer, 2) what they thought was required for LADG to become a standard procedure with an open-ended questionnaire, and 3) the merits and limitations of LADG compared with open distal gastrectomy (ODG)
The most important factor in this study is that surgeons with LADG experience and without LADG experience each noted different requirements for LADG to become a standard procedure
Summary
Laparoscopy-assisted distal gastrectomy (LADG) has garnered interest as a surgical procedure for gastric cancer that is noninvasive and that offers better postoperative outcomes than other available procedures [1]-[4] It has recently become a standard procedure in Japan and Korea [5]-[8]. The purpose of our study was to learn surgeons’ opinions about what requirements should be met before LADG become a standard procedure and to learn about changes in its application after a period of 3 years. With this aim, we conducted a questionnaire survey with open-ended columns at the 2012 Toyama Surgical Procedure Conference and compared it with a similar survey taken in 2009 using content analysis. Surgeons’ practical experience Large number of clinical trials Safety of procedure Stability of radical treatment Shorten operative duration Appropriate application of LADG Social recognition Total LADG: laparoscopy-assisted distal gastrectomy.
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