Abstract
Introduction
Gastric cancer is one of the most common cancers worldwide. Asian countries like Japan, China, and South Korea have a high incidence; those with a low incidence include India, Pakistan, and Thailand1.Gastric cancer is the fourth common cancer and the second leading cause of cancer related deaths worldwide2. The age adjusted stomach cancer incidence among Kashmiri males was36.7/100,000 and among Kashmiri females was 9.9/100,000 in a study from 1986-1989. It indicated that there is a high rate of gastric cancer in Kashmiri population compared to other parts of the country3.
The first laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) was reported in 1994. Since then there have been major breakthroughs in the field of gastric cancer surgery4. Understanding the comparative effectiveness of laparoscopic and open approaches to resection of early-stage gastric cancer is an important issue in the surgical management of this condition5. There has been a tremendous improvement in laparoscopic approach with the use of endoscopic staplers making intracorporeal anastomosis feasible and much easier than before. Many studies showed long term results of laparoscopic gastric surgeries are comparable with those of open gastrectomy6-8.
Objectives
The aim of this study was to evaluate the results of laparoscopic surgeries in gastric carcinoma in a selected Kashmiri population.
Material and Methods
This prospective study was conducted in the Department of General Surgery, Government Medical College, Srinagar over a period of 3 years. Patients were given free choice to undergo either laparoscopic or open resection. Patients were excluded from study if metastasis was detected preoperatively or intra-operatively.
A total number of 30 patients who underwent laparoscopic gastric surgeries for carcinoma stomach were enrolled in the study after a written informed consent in local language.
References
- Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer 2001;37:S4–S66.
- Peter Boyle, Bernard Levin (eds.) (2008). World Cancer Report2008, IARC, Lyon 2008.
- Khuroo MS, Zargar ZA, Mahajan R, et al (1992). High incidence of esophageal and gastric cancer in Kashmir - in a population with special personal and dietary habit. Gut, 33, 11-5.
- Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994;4:146-148
- Kinoshita T, Shibasaki H, Oshiro T, Ooshiro M, Okazumi S, et al. (2011) Comparison of laparoscopy-assisted and total laparoscopic Billroth-I gastrectomy for gastric cancer: A report of short-term outcomes. SurgEndosc 25: 1395-1401.
- Vinuela EF, Gonen M, Brennan MF, Coit DG, Strong VE. Laparoscopic Distal Gastrectomy for Gastric Cancer. Laparoscopic versus open distal gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials and high-quality nonrandomized studies. Ann Surg 2012;255:446-456.
- Zeng YK, Yang ZL, Peng JS, Lin HS, Cai L. Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: evidence from randomized and nonrandomized clinical trials. Ann Surg 2012;256:39-52.
- Jiang L, Yang KH, Guan QL, et al. Laparoscopy-assisted gastrectomy versus open gastrectomy for resectable gastric cancer: an update meta-analysis based on randomized controlled trials. SurgEndosc 2013;27:2466-2480.
- Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 1994; 4: 146-148.
- Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y. A randomized controlled trial comparing open vslaparoscopyassisted distal gastrectomy for the treatment of early gastriccancer: an interim report. Surgery 2002; 131: S306-S311
- Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, RyuSW, Lee HJ, Song KY. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interimreport--a phase III multicenter, prospective, randomized Trial(KLASS Trial). Ann Surg 2010; 251: 417-420 [PMID: 20160637.
- Hayashi H, Ochiai T, Shimada H, Gunji Y. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extra perigastric lymph node dissection for early gastric cancer. Surg Endosc 2005; 19: 1172-1176
- Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M,Recher A, Ponzano C. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005; 241: 232-237
- Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC .Comparative study of laparoscopy-assisted distal gastrectomy andopen distal gastrectomy. J Am Coll Surg 2006; 202: 874-880.
- Lee JH, Yom CK, Han HS. Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer. Surg Endosc 2009; 23: 1759-1763 [PMID: 19057958.
- Viñuela EF, Gonen M, Brennan MF, Coit DG, Strong VE.Laparoscopic versus open distal gastrectomy for gastric cancer:a meta-analysis of randomized controlled trials and high-quality nonrandomized studies. Ann Surg 2012; 255: 446-456.
- Memon MA, Khan S, Yunus RM, Barr R, Memon B. Metaanalysisof laparoscopic and open distal gastrectomy for gastriccarcinoma. Surg Endosc 2008; 22: 1781-1789 [PMID: 18437472.
- Kodera Y, Fujiwara M, Ohashi N, Nakayama G, Koike M, MoritaS, Nakao A. Laparoscopic surgery for gastric cancer: a collectivereview with meta-analysis of randomized trials. J Am CollSurg2010; 211: 677-686.
- Zorcolo L, Rosman AS, Pisano M, Marcon F, Restivo A, Nigri GR,Fancellu A, Melis M. A meta-analysis of prospective randomized trials comparing minimally invasive and open distal gastrectomy for cancer. J Surg Oncol 2011; 104: 544-551.
- Lewis, W.G., Edwards, P., et al. D2 or Not D2? The Gastrectomy Question. Gastric Cancer, 2002; 5: 29-34.
- Cristiano G.S. Huscher, Andrea Mingoli, Giovanna Sgarzini, Andrea Sansonetti, Massimiliano Di Paola, AchilleRecher, and Cecilia Ponzano. Laparoscopic Versus Open Subtotal Gastrectomy for Distal Gastric Cancer: Five-Year Results of a Randomized Prospective Trial. Annals of Surgery 2005 Feb; Vol. 241, No. 2: Page 232-37.
- Junhyun Lee, Dongjin Kim, Wook Kim. Comparison of laparoscopy-assisted and totally laparoscopic Billroth-II distal gastrectomy for gastric cancer. J Korean Surg 2012; 82: 135-142.
- Alfar Nafae, Raiees Ahmad, Amber Aliya, YawarNisar, Pervaze Salam, Imtiyaz Ahmad. D1 versus modified D2 gastrectomy for Ca stomach - A prospective and comparative study. Scientific Research 2016 Jan; Vol. 7, No. 1.
- Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, and Osteen R. Cancer of the Stomach A Patient Care Study by the American College of Surgeons. Annals of Surgery 1993; Vol. 218, No. 5: Page 583-592.
- Degiuli, M., Sasako, M., Ponti, A., Soldati, T., Danese, F. and Calvo, F. Morbidity and Mortality after Modified D2 Gastrectomy for Gastric Cancer: Results of the Italian Gastric Cancer Study Group Prospective Multicenter Surgical Study. Journal of Clinical Oncology, 1998; 16: 1490-1493.
- Huang CM, LinJX, ZhengCH, LiP, XieJWandWangJB. Impact of the Number of Dissected Lymph Nodes on Survival for Gastric Cancer after Distal Subtotal Gastrectomy. Gastroenterology Research and Practice, 2011, Article ID: 476014.
- Kitano S, Adachi Y, Shiraishi N, et al. Laparoscopic-assisted proximal gastrectomy for early gastric carcinomas. Surg Today. 1999;29:389-391.
- Shiraishi N, Adachi Y, Kitano S, et al. Indication for and outcome of laparoscopic-assisted Billroth I gastrectomy. Br J Surg. 1999;86:541-544.
- Adachi Y, Suematsu T, Shiraishi N, et al. Quality of life after laparoscopic-assisted Billroth I gastrectomy. Ann Surg. 1999;229:49-54.
- Adachi Y, Shiraishi N, Shiromizu A, et al. Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg. 2000;135:806-810.
- Kitano S, Shiraishi N, Fujii K, et al. A randomized controlled trial comparing open vs. laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery. 2002; 131(suppl):306-311.
- Yano H, Monden T, Kinuta M, et al. The usefulness of laparoscopy assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer. Gastric Cancer. 2001;4:93-97.
- Reyes CD, Weber KJ, Gagner M, et al. Laparoscopic vs open gastrectomy: a retrospective review. SurgEndosc. 2001;15: 928-931.
- Asao T, Hosouchi Y, Nakabayashi T, et al. Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg. 2001;88:128-132.
- Azagra JS, Goergen M, De Simone P, et al. Minimally invasive surgery for gastric cancer. Surg Endosc. 1999;13:351-357.
- Bonenkamp JJ, Hermans J, Sasako M, et al. Extended lymph-node dissection for gastric cancer. N Engl J Med. 1999; 340:908-914.
- Cuschieri A. Gastrectomy for gastric cancer: definitions and objectives. Br J Surg. 1986;73:513-514.
- Hioki K, Nakane Y, Yamamoto M. Surgical strategy for early gastric cancer. Br J Surg. 1990;77:1330-1334.
- Junhyun Lee, Dongjin Kim, Wook Kim. Comparison of laparoscopy-assisted and totally laparoscopic Billroth-II distal gastrectomy for gastric cancer. J Korean Surg 2012; 82: 135-142.
- Feng LM , Li G , Zhahg HJ , Sun XC. Clinical analysis of 25 gastric cancer cases undergoing totally laparoscopic distal gastrectomy. Chinese Journal of Gastrointestinal Surgery 2013; 16(10): 966-969.
- Han SM, Cha SW, Kim WW, Jeon HM. Totally laparoscopic distal gastrectomy with D1 lymph node dissection. J Minim Invasive Surg, 2004; 7(2): 116-121.
- Pan H, Li T, Huang Z, Yu H, Kong D, Pan C, Jiang Y. Laparoscopic versus open gastric surgery for the treatment of pathological T1N0M0 gastric cancer in elderly patients: a matched study. Sci Rep.2017 May 15; 7(1): 1919.
Corresponding Author
Dr Tanveer Ahmad Yatoo
Post graduate, Department of General Surgery
Government Medical College, Srinagar, India