Journal of Gastric Cancer

  • 제17권1호
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  • Pages.33-42
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  • 2017
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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The Effect of Endoscopic Resection on Short-Term Surgical Outcomes in Patients with Additional Laparoscopic Gastrectomy after Non-Curative Resection for Gastric Cancer

  • Lee, Eun-Gyeong (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ryu, Keun-Won (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Eom, Bang-Wool (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Yoon, Hong-Man (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Kim, Yong-Il (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Cho, Soo-Jeong (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Lee, Jong-Yeul (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Kim, Chan-Gyoo (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Choi, Il-Ju (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center) ;
  • Kim, Young-Woo (Gastric Cancer Branch, Division of Translational & Clinical Research I, Research Institute, National Cancer Center)
  • 투고 : 2016.10.04
  • 심사 : 2016.11.10
  • 발행 : 2017.03.31
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초록

Purpose: Endoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors. Materials and Methods: From January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer. They were divided into 2 groups: (1) with preoperative ESD or (2) without preoperative ESD. Clinicopathologic factors and short-term surgical outcomes were retrospectively evaluated along with risk factors such as preoperative ESD. Results: Several characteristics differed between patients who underwent ESD-surgery (n=199) or surgery alone (n=1,505). The mean interval from the ESD procedure to the operation was 43.03 days. Estimated blood loss, open conversion rate, mean operation time, and length of hospital stay were not different between the 2 groups. Postoperative complications occurred in 23 patients (11.56%) in the ESD-surgery group and in 189 patients (12.56%) in the surgery-only group, and 3 deaths occurred among patients with complications (1 patient [ESD-surgery group] vs. 2 patients [surgery-only group]; P=0.688). A history of ESD was not significantly associated with postoperative complications (P=0.688). Multivariate analysis showed that male sex (P=0.008) and laparoscopic total or proximal gastrectomy (P=0.000) were independently associated with postoperative complications. Conclusions: ESD did not affect short-term surgical outcomes during and after an additional laparoscopic gastrectomy.

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참고문헌

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피인용 문헌

  1. Current Status of Endoscopic Resection of Early Gastric Cancer in Korea vol.70, pp.3, 2017, https://doi.org/10.4166/kjg.2017.70.3.121
  2. Negative Impact of Endoscopic Submucosal Dissection on Short-Term Surgical Outcomes of Subsequent Laparoscopic Distal Gastrectomy for Gastric Cancer vol.27, pp.1, 2017, https://doi.org/10.1245/s10434-019-07962-z
  3. Operative safety of curative gastrectomy after endoscopic submucosal dissection (ESD) for early gastric cancer - 1:2 propensity score matching analysis: A retrospective single-center study (cohort stu vol.80, pp.None, 2017, https://doi.org/10.1016/j.ijsu.2020.06.041
  4. Effect of endoscopic resection on short-term surgical outcomes of subsequent laparoscopic gastrectomy: a meta-analysis vol.19, pp.1, 2017, https://doi.org/10.1186/s12957-021-02230-5
  5. Effect of non-curative endoscopic submucosal dissection on short-term outcomes of subsequent surgery for early gastric cancer vol.45, pp.1, 2022, https://doi.org/10.1016/j.asjsur.2021.05.008