Technical aspects, short- and long-term outcomes of laparoscopic and robotic D2-lymphadectomy in gastric cancer

Efstathios Kotidis, Manousos George Pramateftakis Dimitris Pramateftakis, Dimitris Tatsis

Overview

Gastric cancer is a common malignancy and its radical excision with an adequate lymph node resection provides an improved oncologic outcome. D2 lymphadenectomy in distal or total gastrectomy is considered a highly desirable technique for curable early or locally advanced gastric cancer. Many studies with high-level of evidence confirm the importance of the application of minimally invasive techniques in improving the short and long term outcomes of patients who undergo gastrectomy.

Summary

The superiority of laparoscopic gastrectomy towards the open technique is widely accepted, yet the proven acceptance of minimally invasive robotic techniques is still debated and not scientifically established. Technical challenges are the main point of discussion among the experts on the field, as well as the advantages of laparoscopic and robotic assisted gastrectomy over the conventional open. This review provides a comparison on technical aspects, the short and long term outcomes of open and minimally invasive gastrectomy with D2 lymphadenectomy in early and advanced gastric cancer.

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Author Comments

Mr dimitris-tatsis, DDS, MD
Mr dimitris-tatsis, DDS, MD
Aristotle University of Thessaloniki School of Dentistry
Oral and Maxillofiacial Surgery resident
Thessaloniki, GH G.Papanikolaou | Greece
The minimally invasive techniques for treating gastric cancer seem to be rather promising, rapidly improving the short-and long-term outcomes of patients with early and advanced gastric cancer. Technical aspects are more challenging in laparoscopic and robotic gastrectomy, but this seem to be related with the surgeon’s expertise and experience. There is a need for further well-designed randomized control trials with large sample size comparing the laparoscopic and robotic procedure to the open, especially on the long-term outcomes of patients.Mr dimitris-tatsis, DDS, MD

Resources

JBUON
https://www.jbuon.com/archive/24-3-889.pdf

Technical aspects, short- and long-term outcomes of laparoscopic and robotic D2-lymphadectomy in gastric cancer.

Authors:
Mr dimitris-tatsis, DDS, MD
Mr dimitris-tatsis, DDS, MD
Aristotle University of Thessaloniki School of Dentistry
Oral and Maxillofiacial Surgery resident
Thessaloniki, GH G.Papanikolaou | Greece

J BUON 2019 May-Jun;24(3):889-896

Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Purpose: Gastric cancer is a common malignancy and its radical excision with an adequate lymph node resection provides an improved oncologic outcome. D2 lymphadenectomy in distal or total gastrectomy is considered a highly desirable technique for curable early or locally advanced gastric cancer. Many studies with high-level of evidence confirm the importance of the application of minimally invasive techniques in improving the short and long term outcomes of patients who undergo gastrectomy.

Methods: A MEDLINE search was performed with the following keywords; "d2 gastrectomy open laparoscopic", "d2 gastrectomy open robotic" and "d2 gastrectomy laparoscopic robotic". The search was narrowed on randomized control trials (RCT).

Results: 6 studies in total are included in the study; 5 RCTs on open vs laparoscopic group and 1 RCT on open vs robotic group. There is currently no RCT comparing the laparoscopic vs robotic techniques.

Conclusions: The superiority of laparoscopic gastrectomy towards the open technique is widely accepted, yet the proven acceptance of minimally invasive robotic techniques is still debated and not scientifically established. Technical challenges are the main point of discussion among the experts on the field, as well as the advantages of laparoscopic and robotic assisted gastrectomy over the conventional open. This review provides a comparison on technical aspects, the short and long term outcomes of open and minimally invasive gastrectomy with D2 lymphadenectomy in early and advanced gastric cancer.

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Source
March 2020
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1.344 Impact Factor

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