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Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial
Abstract
Purpose: The safety and efficacy of radical laparoscopic distal gastrectomy (LG) with D2 lymphadenectomy for the treatment of advanced gastric cancer (AGC) remain controversial. We conducted a randomized controlled trial to compare laparoscopic and conventional open distal gastrectomy with D2 lymph node dissections for AGC. Patients and Methods: Between September 2012 and December 2014, 1,056 patients with clinical stage T2-4aN0-3M0 gastric cancer were eligible for inclusion. They were randomly assigned to either the LG with D2 lymphadenectomy group (n = 528) or the open gastrectomy (OG) with D2 lymphadenectomy group (n = 528). Fifteen experienced surgeons from 14 institutions in China participated in the study. The morbidity and mortality within 30 days after surgery between the LG (n = 519) and the OG (n = 520) groups were compared on the basis of the modified intention-to-treat principle. Postoperative complications were stratified according to the Clavien-Dindo classification. Results: The compliance rates of D2 lymphadenectomy were similar between the LG and OG groups (99.4% v 99.6%; P = .845). The postoperative morbidity was 15.2% in the LG group and 12.9% in OG group with no significant difference (difference, 2.3%; 95% CI, –1.9 to 6.6; P = .285). The mortality rate was 0.4% for the LG group and zero for the OG group (difference, 0.4%; 95% CI, –0.4 to 1.4; P = .249). The distribution of severity was similar between the two groups (P = .314). Conclusion: Experienced surgeons can safely perform LG with D2 lymphadenectomy for AGC.
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Self-citationChemotherapy use and survival among young and middle-aged patients with gastric cancer
Jiang, Y., Xie, J., Huang, W., Chen, H., Xi, S., Li, T., Chen, C., Sun, Z., Hu, Y., Liu, W., et al. (2020) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000000253 · Cited by 18
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Metadata
- Authors
- Hu, Y., Huang, C., Sun, Y., Su, X., Cao, H., Hu, J., Xue, Y., Suo, J., Tao, K., He, X., Wei, H., Ying, M., Hu, W., Du, X., Chen, P., Liu, H., Zheng, C., Liu, F., Yu, J., Li, Z., Zhao, G., Chen, X., Wang, K., Li, P., Xing, J., & Li, G.
- Venue
- Journal of Clinical Oncology
- Published
- 2016-04-20
- Volume
- 34
- Issue
- 12
- Pages
- 1350-1357
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2287250785
- Cited by
- 686
- References
- 24
- FWCI
- 61.97
- Type
- journal article
- Language
- en
- Open access
- closed
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- Hu, Y., Huang, C., Sun, Y., Su, X., Cao, H., Hu, J., Xue, Y., Suo, J., Tao, K., He, X., Wei, H., Ying, M., Hu, W., Du, X., Chen, P., Liu, H., Zheng, C., Liu, F., Yu, J., . . . Li, G. (2016). Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2015.63.7215
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