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Gastric Cancer Resection
that was not statistically significant , which was supported 2. Ibrahim AS, Khaled HM, Mikhail NN, et al. Cancer incidence in Egypt:
by other authors. 6,15 The postoperative overall complication results of the national population-based cancer registry program.
rate was 20.0% in OG vs 12.5% in LG, a difference that was not J Cancer Epidemiol 2014;2014(January):1–18. DOI: 10.1155/2014/437971.
statistically significant. Anastomosis leakage was reported more 3. Kodera Y, Sano T. Japanese gastric cancer treatment guidelines
in LG and more at total gastrectomy patients. This was supported 2014 (ver. 4). Gastric Cancer 2017;20(1):1–19. DOI: 10.1007/s10120-
016-0622-4.
by other studies which reported that anastomosis leakage 4. Lee HJ, Yang HK. Laparoscopic gastrectomy for gastric cancer. Dig
occurred in 0 to 17% of total gastrectomy patients, in 1.1 to 2.7% Surg 2013;30(2):132–141. DOI: 10.1159/000350884.
of distal gastrectomy patients, and more liability of fistula in LG 5. Son T, Hyung WJ. Laparoscopic gastric cancer surgery: current evidence
patients. 14,16,17 and future perspectives. World J Gastroenterol 2016;22(2):727.
Luminal bleeding is a serious complication that can lead to DOI: 10.3748/wjg.v22.i2.727.
severe morbidity and even mortality if not treated properly. Other 6. Gurusamy KS. Laparoscopic versus open gastrectomy for gastric
authors reported rates of anastomotic hemorrhage ranged from 0 cancer. In: Gurusamy KS, editor. Cochrane Database Syst Rev
18
to 2.0%. but it is lethal if not treated immediately. Methods: Of 1400 2014;2014(11). DOI: 10.1002/14651858.CD011389.
patients with gastric cancer who underwent gastrectomy between 7. Orditura M, Galizia G, Sforza V, et al. Treatment of gastric cancer. World
J Gastroenterol 2014;20(7):1635–1649. DOI: 10.3748/wjg.v20.i7.1635.
September 2002 and December 2007, postoperative anastomotic 8. Kim MC, Jung GJ, Kim HH. Learning curve of laparoscopy-assisted
hemorrhage was observed in 6 patients. The surgical procedures, distal gastrectomy with systemic lymphadenectomy for early gastric
bleeding sites, methods of hemostasis, and clinical courses of these cancer. World J Gastroenterol 2005;11(47):7508–7511. DOI: 10.3748/
6 patients were analyzed. Results: Of the 1400 patients, 878, 72, and wjg.v11.i47.7508.
450 underwent distal, proximal, and total gastrectomy, respectively. 9. Kim HG, Park JH, Jeong SH, et al. Totally laparoscopic distal
The bleeding sites were as follows: transection line of the stomach gastrectomy after learning curve completion: comparison
using a linear stapler (n = 1 In our study, we reported two cases of with laparoscopy-assisted distal gastrectomy. J Gastric Cancer
2013;13(1):26–33. DOI: 10.5230/jgc.2013.13.1.26.
luminal bleeding who were treated successfully by conservative 10. Marchesi F, De Sario G, Cecchini S, et al. Laparoscopic subtotal
management. Although only one mortality was reported only in gastrectomy for the treatment of advanced gastric cancer:
OG group, the difference was not statistically significant. This agrees a comparison with open procedure at the beginning of the learning
with the results of the Korean multicenter trial named KLASS (Korean curve. Acta Biomed 2017;88(3):302–309. DOI: 10.23750/ABM.
Laparoendoscopic Gastrointestinal Surgery Study; NCT00452751), V88I3.6541.
which concluded that there was no significant difference in the 11. Gong Y, Wang B, Wang H. A propensity score-matching analysis
morbidity and mortality between the OG and LG groups of GC comparing the oncological outcomes of laparoscopic and
resection. 19 open gastrectomy in patients with gastric carcinoma. J BUON
2017;22(1):134–140. PMID: 28365946
The current study has some limitations as the small number 12. Beyer K, Baukloh AK, Kamphues C, et al. Laparoscopic versus open
of patients and being a single-center study. Further clinical trials gastrectomy for locally advanced gastric cancer: a systematic review
on larger number of patients and involving multiple centers are and meta-analysis of randomized controlled studies. World J Surg
still needed. Oncol 2019;17(1):68. DOI: 10.1186/s12957-019-1600-1.
In conclusion, for resectable GC cases, early results showed 13. Kim HH, Han SU, Kim MC, et al. Long-term results of laparoscopic
that laparoscopic D2 gastrectomy has comparable outcomes to gastrectomy for gastric cancer: a large-scale case-control and case-
OG regarding intraoperative blood loss, number of harvested LN, matched Korean multicenter study. J Clin Oncol 2014;32(7):627–633.
operative organ injury, length of hospital stay, time to first flatus, DOI: 10.1200/JCO.2013.48.8551.
postoperative morbidity, and mortality. However, the laparoscopic 14. Hu Y, Huang C, Sun Y, et al. Morbidity and mortality of laparoscopic
versus open D2 distal gastrectomy for advanced gastric cancer:
approach was longer than the open one for the early surgeon’s a randomized controlled trial. J Clin Oncol 2016;34(12):1350–1357.
experience. Larger trials are needed for further evaluation of the DOI: 10.1200/JCO.2015.63.7215.
early and late outcomes. 15. Mitrousias AS, Makris MC, Zani Z, et al. Laparoscopic versus
open gastrectomy with D2 lymph node dissection for advanced
AcknowledgMents gastric cancer: a systematic review. J BUON 2019;24(3):872–882.
PMID: 31424636
The authors would like to thank Dr Essam Eldeen MO Mahran, 16. Lan X, Xi H, Zhang K, et al. Comparison of complications
Department of Tropical Medicine and Gastroenterology, Faculty following open, laparoscopic and robotic gastrectomy. Zhonghua
of Medicine, Assiut University, for helping in patients’ recruitment Wei Chang Wai Ke Za Zhi 2017;20(2):184–189. DOI: 10.3760/
through endoscopy unit. CMA.J.ISSN.1671-0274.2017.02.014
17. Hummel R, Bausch D. Anastomotic leakage after upper gastrointestinal
surgery: surgical treatment. Visc Med 2017;33(3):207–211. DOI:
orcId 10.1159/000470884.
Mohamed G Taher https://orcid.org/0000-0003-0786-6045 18. Tanizawa Y, Bando E, Kawamura T, et al. Early postoperative
anastomotic hemorrhage after gastrectomy for gastric cancer. Gastric
Cancer 2010;13(1):50–57. DOI: 10.1007/s10120-009-0535-6.
references 19. Lee CM, Park JH, Choi CI, et al. A multi-center prospective randomized
1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: controlled trial (phase III) comparing the quality of life between
GLOBOCAN estimates of incidence and mortality worldwide for laparoscopy-assisted distal gastrectomy and totally laparoscopic
36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. distal gastrectomy for gastric Cancer (study protocol). BMC Cancer
DOI: 10.3322/caac.21492. 2019;19(1):206. DOI: 10.1186/s12885-019-5396-8.

110 World Journal of Laparoscopic Surgery, Volume 14 Issue 2 (May–August 2021)