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Laparoscopic Pylorus Preserving Gastrectomy vs Distal Gastrectomy for Early Gastric Cancer; A Multicenter Randomized Controlled Trial (KLASS-04).
Lee, Hyuk-Joon; Kim, Young-Woo; Park, Do Joong; Han, Sang Uk; Ryu, Keun Won; Kim, Hyung-Ho; Hyung, Woo Jin; Park, Ji-Ho; Suh, Yun-Suhk; Kwon, Oh-Kyung; Kim, Wook; Park, Young-Kyu; Yoon, Hong Man; Ahn, Sang-Hoon; Kong, Seong-Ho; Yang, Han-Kwang.
Afiliación
  • Lee HJ; Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Kim YW; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Park DJ; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
  • Han SU; Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Ryu KW; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Kim HH; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Hyung WJ; Department of Surgery, Ajou University Hospital, Suwon, Republic of Korea.
  • Park JH; Center for Gastric Cancer, National Cancer Center, Goyang, Republic of Korea.
  • Suh YS; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Kwon OK; Department of Surgery, Yonsei University Severance Hospital, Seoul, Republic of Korea.
  • Kim W; Department of Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea.
  • Park YK; Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Yoon HM; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Ahn SH; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Kong SH; Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
  • Yang HK; Department of Surgery, Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Republic of Korea.
Ann Surg ; 2024 Sep 02.
Article en En | MEDLINE | ID: mdl-39219553
ABSTRACT

OBJECTIVE:

To evaluate the long-term outcomes of laparoscopic pylorus preserving gastrectomy (LPPG) with laparoscopic distal gastrectomy (LDG) for early gastric cancer (EGC). SUMMARY BACKGROUND DATA PPG is considered as a function preserving surgery for EGC. However, there has been no multicenter randomized controlled trial comparing PPG with DG until now.

METHODS:

A multicenter randomized controlled trial (KLASS-04) with 256 patients with cT1N0M0 gastric cancer located in the mid portion of the stomach was conducted. The primary endpoint was the incidence of dumping syndrome at postoperative 1 year. Secondary endpoints included survival and recurrence, gallstone formation, nutritional parameters, gastroscopic findings, and quality of life (QOL) for 3 years.

RESULTS:

In the intention-to-treat analyses, there was no difference in the incidence of dumping syndrome at one year postoperatively (13.2% in LPPG vs. 15.8% in LDG, P=0.622). Gallstone formation after surgery was significantly lower in LPPG than in LDG (2.33% vs. 8.66%, P=0.026). Hemoglobin (+0.01 vs. -0.76 gm/dL, P<0.001) and serum protein (-0.15 vs. -0.35 gm/dL, P=0.002) were significantly preserved after LPPG. However, reflux esophagitis (17.8% vs. 6.3%, P=0.005) and grade IV delayed gastric emptying (16.3% vs. 3.9%, P=0.001) were more common in LPPG. Changes in body weight and postoperative QOL were not significantly different between groups. Three-year overall survival and disease-free survival were not different (1 case of recurrence of in each group, P=0.98).

CONCLUSIONS:

LPPG can be used as an alternative surgical option for cT1N0M0 gastric cancer in the mid portion of the stomach.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos