The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Woo Jin Hyung - One of the best experts on this subject based on the ideXlab platform.
-
effect of laparoscopic distal Gastrectomy vs open distal Gastrectomy on long term survival among patients with stage i gastric cancer the klass 01 randomized clinical trial
JAMA Oncology, 2019Co-Authors: Han-kwang Yang, Kyo Young Song, Do Joong Park, Woo Jin HyungAbstract:Importance Laparoscopic distal Gastrectomy is gaining popularity over open distal Gastrectomy for gastric cancer because of better early postoperative outcomes. However, to our knowledge, no studies have proved whether laparoscopic distal Gastrectomy is oncologically equivalent to open distal Gastrectomy. Objective To examine whether the long-term survival among patients with stage I gastric cancer undergoing laparoscopic distal Gastrectomy is noninferior to that among patients undergoing open distal Gastrectomy. Design The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group, which includes 15 surgeons from 13 institutes, conducted a phase 3, multicenter, open-label, noninferiority, prospective randomized clinical trial (KLASS-01) of patients with histologically proven, preoperative clinical stage I gastric adenocarcinoma from January 5, 2006, to August 23, 2010. Survival and recurrence status of the patients was determined in December 2016. Interventions Patients were randomly assigned (1:1) to laparoscopic distal Gastrectomy (n = 705) or open distal Gastrectomy (n = 711). Of these patients, 85 received a surgical approach opposite the one to which they were randomized (63 randomized to the open surgery group and 22 to the laparoscopic group). Main Outcomes and Measures Difference in 5-year overall survival between the laparoscopic and open distal Gastrectomy groups. The noninferiority margin was prespecified as −5% (corresponding hazard ratio of 1.54), with an assumed survival of 90% after 5 years in the open surgery group. Results Among the 1416 patients (mean [SD] age, 57.3 [11.1] years; 940 [66.4%] male) included in the study, the 5-year overall survival rates were 94.2% in the laparoscopic group and 93.3% in the open surgery group (log-rankP = .64). Intention-to-treat analysis confirmed the noninferiority of the laparoscopic approach compared with the open approach (difference, 0.9 percentage points; 1-sided 97.5% CI, −1.6 to infinity). The 5-year cancer-specific survival rates were similar between the 2 groups (97.1% in the laparoscopic group and 97.2% in the open surgery group, log-rankP = .91; difference, −0.03 percentage points; 1-sided 97.5% CI, −1.8 to infinity). Per-protocol analysis results were consistent with the intention-to-treat results for overall and cancer-specific survival rates. Conclusions and Relevance The KLASS-01 trial revealed similar overall and cancer-specific survival rates between patients receiving laparoscopic and open distal Gastrectomy. Laparoscopic distal Gastrectomy is an oncologically safe alternative to open surgery for stage I gastric cancer. Trial Registration ClinicalTrials.gov identifier:NCT00452751
-
Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non curable factor regatta a phase 3 randomised controlled trial
Lancet Oncology, 2016Co-Authors: Kazumasa Fujitani, Woo Jin Hyung, Han-kwang Yang, Junki Mizusawa, Youngwoo Kim, Masanori Terashima, Sanguk Han, Yoshiaki Iwasaki, Akinori Takagane, Do Joong ParkAbstract:Summary Background Chemotherapy is the standard of care for incurable advanced gastric cancer. Whether the addition of Gastrectomy to chemotherapy improves survival for patients with advanced gastric cancer with a single non-curable factor remains controversial. We aimed to investigate the superiority of Gastrectomy followed by chemotherapy versus chemotherapy alone with respect to overall survival in these patients. Methods We did an open-label, randomised, phase 3 trial at 44 centres or hospitals in Japan, South Korea, and Singapore. Patients aged 20–75 years with advanced gastric cancer with a single non-curable factor confined to either the liver (H1), peritoneum (P1), or para-aortic lymph nodes (16a1/b2) were randomly assigned (1:1) in each country to chemotherapy alone or Gastrectomy followed by chemotherapy by a minimisation method with biased-coin assignment to balance the groups according to institution, clinical nodal status, and non-curable factor. Patients, treating physicians, and individuals who assessed outcomes and analysed data were not masked to treatment assignment. Chemotherapy consisted of oral S-1 80 mg/m 2 per day on days 1–21 and cisplatin 60 mg/m 2 on day 8 of every 5-week cycle. Gastrectomy was restricted to D1 lymphadenectomy without any resection of metastatic lesions. The primary endpoint was overall survival, analysed by intention to treat. This study is registered with UMIN-CTR, number UMIN000001012. Findings Between Feb 4, 2008, and Sept 17, 2013, 175 patients were randomly assigned to chemotherapy alone (86 patients) or Gastrectomy followed by chemotherapy (89 patients). After the first interim analysis on Sept 14, 2013, the predictive probability of overall survival being significantly higher in the Gastrectomy plus chemotherapy group than in the chemotherapy alone group at the final analysis was only 13·2%, so the study was closed on the basis of futility. Overall survival at 2 years for all randomly assigned patients was 31·7% (95% CI 21·7–42·2) for patients assigned to chemotherapy alone compared with 25·1% (16·2–34·9) for those assigned to Gastrectomy plus chemotherapy. Median overall survival was 16·6 months (95% CI 13·7–19·8) for patients assigned to chemotherapy alone and 14·3 months (11·8–16·3) for those assigned to Gastrectomy plus chemotherapy (hazard ratio 1·09, 95% CI 0·78–1·52; one-sided p=0·70). The incidence of the following grade 3 or 4 chemotherapy-associated adverse events was higher in patients assigned to Gastrectomy plus chemotherapy than in those assigned to chemotherapy alone: leucopenia (14 patients [18%] vs two [3%]), anorexia (22 [29%] vs nine [12%]), nausea (11 [15%] vs four [5%]), and hyponatraemia (seven [9%] vs four [5%]). One treatment-related death occurred in a patient assigned to chemotherapy alone (sudden cardiopulmonary arrest of unknown cause during the second cycle of chemotherapy) and one occurred in a patient assigned to chemotherapy plus Gastrectomy (rapid growth of peritoneal metastasis after discharge 12 days after surgery). Interpretation Since Gastrectomy followed by chemotherapy did not show any survival benefit compared with chemotherapy alone in advanced gastric cancer with a single non-curable factor, Gastrectomy cannot be justified for treatment of patients with these tumours. Funding The Ministry of Health, Labour and Welfare of Japan and the Korean Gastric Cancer Association.
-
decreased morbidity of laparoscopic distal Gastrectomy compared with open distal Gastrectomy for stage i gastric cancer short term outcomes from a multicenter randomized controlled trial klass 01
Annals of Surgery, 2016Co-Authors: Woo Jin Hyung, Han-kwang Yang, Do Joong Park, Kyo Young SongAbstract:Objective:To determine the safety of laparoscopy-assisted distal Gastrectomy (LADG) compared with open distal Gastrectomy (ODG) in patients with clinical stage I gastric cancer in Korea.Background:There is still a lack of large-scale, multicenter randomized trials regarding the safety of LADG.Method
-
Robotic Gastrectomy for elderly gastric cancer patients: comparisons with robotic Gastrectomy in younger patients and laparoscopic Gastrectomy in the elderly
Gastric Cancer, 2015Co-Authors: Naoki Okumura, Ji Yeong An, Woo Jin HyungAbstract:Robotic surgery for gastric cancer has been adopted to overcome technical difficulties in performing laparoscopic Gastrectomy. This study aimed to investigate the feasibility and safety of robotic Gastrectomy in elderly gastric cancer patients. Patients who underwent laparoscopic or robotic Gastrectomy from 2003 to 2010 in a single high-volume center were included in this study. We retrospectively compared preoperative characteristics, perioperative factors, and oncological parameters among an elderly (≥70 years old) robotic Gastrectomy group (n = 49), a younger (
-
Robotic Gastrectomy for gastric cancer.
Journal of Surgical Oncology, 2015Co-Authors: Woo Jin HyungAbstract:Since the first application of laparoscopic surgery for gastric cancer was performed, radical Gastrectomy with minimally invasive approach has gained popularity worldwide. However, due to technically demanding procedures of conventional laparoscopic Gastrectomy with D2 lymphadenectomy, adoption of laparoscopic Gastrectomy for advanced gastric cancer has been limited. To overcome this technical difficulty, several surgeons started the robotic Gastrectomy for gastric cancer using the da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). Advantages of robotic surgery for surgeons such as articulating EndoWrist® instruments, an improved 3D magnified operative view, and tremor filtering facilitate more precise and delicate lymph node dissection compared to conventional laparoscopic surgery. Although several retrospective and small prospective studies revealed the feasibility and safety of robotic Gastrectomy for gastric cancer, advantages of robotic Gastrectomy from an oncologic point of view are still to be clarified. Here, we documented our current practice of robotic surgery for gastric cancer and review of the literatures, as well as the potential advantages of robotic approach, especially for D2 lymphadenectomy.
Seung Ho Choi - One of the best experts on this subject based on the ideXlab platform.
-
Effect of histologic differences between biopsy and final resection on treatment outcomes in early gastric cancer
Surgical Endoscopy, 2019Co-Authors: Hong Jin Yoon, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, In Gyu Kwon, Seung Ho ChoiAbstract:Background and study aims Biopsy-based histologic diagnosis is important in determining the treatment strategy for early gastric cancer (EGC). However, there are few studies on how histologic discrepancy may affect patients’ treatment outcomes. We aimed to investigate the impact of histopathologic differences between biopsy and final specimens from endoscopic resection (ER) or Gastrectomy on treatment outcomes in patients with EGC. We also examined the predictive factors of histologic discrepancy. Patients and methods We analyzed the data of 1851 patients with EGC treated with ER or Gastrectomy. We compared the histology between biopsies and final resected specimens from ER or Gastrectomy. We also examined changes in treatment outcomes according to histologic differences. Results Histologic discrepancy was observed in 11.9% of patients in the ER group and 10.7% of those in the Gastrectomy group. In patients treated with ER who showed histologic discrepancy, 80.9% showed differentiated-type EGC (D-EGC) on biopsy but undifferentiated-type-EGC (UD-EGC) after ER, of which 78.9% were non-curative resection. In patients treated with Gastrectomy who showed histologic discrepancy, 39% showed UD-EGC on biopsy but showed D-EGC after Gastrectomy. A total of these patients had absolute and expanded indications for ER. Moderately differentiated and poorly differentiated adenocarcinoma on biopsy were predictive factors of histologic discrepancy in UD-EGC and D-EGC on final resection, respectively. Conclusions About 10% of patients showed histologic discrepancy between biopsy and final resection with ER or Gastrectomy. Histologic discrepancy can affect treatment outcomes, such as non-curative resection in ER or missing the opportunity for ER in Gastrectomy.
-
Role of robotic Gastrectomy using da Vinci system compared with laparoscopic Gastrectomy: initial experience of 20 consecutive cases
Surgical Endoscopy, 2009Co-Authors: Jyewon Song, Wook Ho Kang, Sung Jin Oh, Woo Jin Hyung, Seung Ho ChoiAbstract:Background Robotic surgery was invented to overcome the demerits of laparoscopic surgery. However, the role of robotic surgery in Gastrectomy has rarely been reported. This study aimed to evaluate the use of robot-assisted distal subtotal Gastrectomy to facilitate surgical training for gastric cancer. Methods Twenty gastric cancer patients who underwent robotic Gastrectomy from July 2005 to November 2006 were compared with 20 initial patients who underwent laparoscopic subtotal Gastrectomy from May 2003 to August 2003 and 20 recent patients who underwent laparoscopic subtotal Gastrectomy during the same period as the 20 robotic Gastrectomy procedures by the same surgeon. Result All 60 patients underwent subtotal gastrectomies with gastroduodenostomy without open or laparoscopic conversion. Operation time for robotic Gastrectomy, initial laparoscopic Gastrectomy, and recent laparoscopic Gastrectomy was 230 min (range 171–312 min), 289.5 min (range 190–450 min), and 134.1 min (range 90–260 min). The number of retrieved lymph nodes was 35.3 ± 10.5, 31.5 ± 17.1, and 42.7 ± 14.9, respectively. Hospital stay was 5.7, 7.7, and 6.2 days, respectively. Postoperative complication occurred in two patients in recent laparoscopic Gastrectomy and one patient each in robotic and initial laparoscopic Gastrectomy. Conclusion In this context, it could be assumed that experienced laparoscopic surgeons could perform robotic Gastrectomy with a certain level of skill, even in initial series.
-
role of robotic Gastrectomy using da vinci system compared with laparoscopic Gastrectomy initial experience of 20 consecutive cases
Surgical Endoscopy and Other Interventional Techniques, 2009Co-Authors: Jyewon Song, Wook Ho Kang, Sung Jin Oh, Woo Jin Hyung, Seung Ho ChoiAbstract:Background Robotic surgery was invented to overcome the demerits of laparoscopic surgery. However, the role of robotic surgery in Gastrectomy has rarely been reported. This study aimed to evaluate the use of robot-assisted distal subtotal Gastrectomy to facilitate surgical training for gastric cancer.
Han-kwang Yang - One of the best experts on this subject based on the ideXlab platform.
-
effect of laparoscopic distal Gastrectomy vs open distal Gastrectomy on long term survival among patients with stage i gastric cancer the klass 01 randomized clinical trial
JAMA Oncology, 2019Co-Authors: Han-kwang Yang, Kyo Young Song, Do Joong Park, Woo Jin HyungAbstract:Importance Laparoscopic distal Gastrectomy is gaining popularity over open distal Gastrectomy for gastric cancer because of better early postoperative outcomes. However, to our knowledge, no studies have proved whether laparoscopic distal Gastrectomy is oncologically equivalent to open distal Gastrectomy. Objective To examine whether the long-term survival among patients with stage I gastric cancer undergoing laparoscopic distal Gastrectomy is noninferior to that among patients undergoing open distal Gastrectomy. Design The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group, which includes 15 surgeons from 13 institutes, conducted a phase 3, multicenter, open-label, noninferiority, prospective randomized clinical trial (KLASS-01) of patients with histologically proven, preoperative clinical stage I gastric adenocarcinoma from January 5, 2006, to August 23, 2010. Survival and recurrence status of the patients was determined in December 2016. Interventions Patients were randomly assigned (1:1) to laparoscopic distal Gastrectomy (n = 705) or open distal Gastrectomy (n = 711). Of these patients, 85 received a surgical approach opposite the one to which they were randomized (63 randomized to the open surgery group and 22 to the laparoscopic group). Main Outcomes and Measures Difference in 5-year overall survival between the laparoscopic and open distal Gastrectomy groups. The noninferiority margin was prespecified as −5% (corresponding hazard ratio of 1.54), with an assumed survival of 90% after 5 years in the open surgery group. Results Among the 1416 patients (mean [SD] age, 57.3 [11.1] years; 940 [66.4%] male) included in the study, the 5-year overall survival rates were 94.2% in the laparoscopic group and 93.3% in the open surgery group (log-rankP = .64). Intention-to-treat analysis confirmed the noninferiority of the laparoscopic approach compared with the open approach (difference, 0.9 percentage points; 1-sided 97.5% CI, −1.6 to infinity). The 5-year cancer-specific survival rates were similar between the 2 groups (97.1% in the laparoscopic group and 97.2% in the open surgery group, log-rankP = .91; difference, −0.03 percentage points; 1-sided 97.5% CI, −1.8 to infinity). Per-protocol analysis results were consistent with the intention-to-treat results for overall and cancer-specific survival rates. Conclusions and Relevance The KLASS-01 trial revealed similar overall and cancer-specific survival rates between patients receiving laparoscopic and open distal Gastrectomy. Laparoscopic distal Gastrectomy is an oncologically safe alternative to open surgery for stage I gastric cancer. Trial Registration ClinicalTrials.gov identifier:NCT00452751
-
Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non curable factor regatta a phase 3 randomised controlled trial
Lancet Oncology, 2016Co-Authors: Kazumasa Fujitani, Woo Jin Hyung, Han-kwang Yang, Junki Mizusawa, Youngwoo Kim, Masanori Terashima, Sanguk Han, Yoshiaki Iwasaki, Akinori Takagane, Do Joong ParkAbstract:Summary Background Chemotherapy is the standard of care for incurable advanced gastric cancer. Whether the addition of Gastrectomy to chemotherapy improves survival for patients with advanced gastric cancer with a single non-curable factor remains controversial. We aimed to investigate the superiority of Gastrectomy followed by chemotherapy versus chemotherapy alone with respect to overall survival in these patients. Methods We did an open-label, randomised, phase 3 trial at 44 centres or hospitals in Japan, South Korea, and Singapore. Patients aged 20–75 years with advanced gastric cancer with a single non-curable factor confined to either the liver (H1), peritoneum (P1), or para-aortic lymph nodes (16a1/b2) were randomly assigned (1:1) in each country to chemotherapy alone or Gastrectomy followed by chemotherapy by a minimisation method with biased-coin assignment to balance the groups according to institution, clinical nodal status, and non-curable factor. Patients, treating physicians, and individuals who assessed outcomes and analysed data were not masked to treatment assignment. Chemotherapy consisted of oral S-1 80 mg/m 2 per day on days 1–21 and cisplatin 60 mg/m 2 on day 8 of every 5-week cycle. Gastrectomy was restricted to D1 lymphadenectomy without any resection of metastatic lesions. The primary endpoint was overall survival, analysed by intention to treat. This study is registered with UMIN-CTR, number UMIN000001012. Findings Between Feb 4, 2008, and Sept 17, 2013, 175 patients were randomly assigned to chemotherapy alone (86 patients) or Gastrectomy followed by chemotherapy (89 patients). After the first interim analysis on Sept 14, 2013, the predictive probability of overall survival being significantly higher in the Gastrectomy plus chemotherapy group than in the chemotherapy alone group at the final analysis was only 13·2%, so the study was closed on the basis of futility. Overall survival at 2 years for all randomly assigned patients was 31·7% (95% CI 21·7–42·2) for patients assigned to chemotherapy alone compared with 25·1% (16·2–34·9) for those assigned to Gastrectomy plus chemotherapy. Median overall survival was 16·6 months (95% CI 13·7–19·8) for patients assigned to chemotherapy alone and 14·3 months (11·8–16·3) for those assigned to Gastrectomy plus chemotherapy (hazard ratio 1·09, 95% CI 0·78–1·52; one-sided p=0·70). The incidence of the following grade 3 or 4 chemotherapy-associated adverse events was higher in patients assigned to Gastrectomy plus chemotherapy than in those assigned to chemotherapy alone: leucopenia (14 patients [18%] vs two [3%]), anorexia (22 [29%] vs nine [12%]), nausea (11 [15%] vs four [5%]), and hyponatraemia (seven [9%] vs four [5%]). One treatment-related death occurred in a patient assigned to chemotherapy alone (sudden cardiopulmonary arrest of unknown cause during the second cycle of chemotherapy) and one occurred in a patient assigned to chemotherapy plus Gastrectomy (rapid growth of peritoneal metastasis after discharge 12 days after surgery). Interpretation Since Gastrectomy followed by chemotherapy did not show any survival benefit compared with chemotherapy alone in advanced gastric cancer with a single non-curable factor, Gastrectomy cannot be justified for treatment of patients with these tumours. Funding The Ministry of Health, Labour and Welfare of Japan and the Korean Gastric Cancer Association.
-
decreased morbidity of laparoscopic distal Gastrectomy compared with open distal Gastrectomy for stage i gastric cancer short term outcomes from a multicenter randomized controlled trial klass 01
Annals of Surgery, 2016Co-Authors: Woo Jin Hyung, Han-kwang Yang, Do Joong Park, Kyo Young SongAbstract:Objective:To determine the safety of laparoscopy-assisted distal Gastrectomy (LADG) compared with open distal Gastrectomy (ODG) in patients with clinical stage I gastric cancer in Korea.Background:There is still a lack of large-scale, multicenter randomized trials regarding the safety of LADG.Method
-
Open Total Gastrectomy and Splenectomy
Surgery for Cancers of the Gastrointestinal Tract, 2014Co-Authors: Han-kwang Yang, Seung-young OhAbstract:Open total Gastrectomy remains the standard approach to complete surgica; resection of the stomach. Although laparoscopic techniques and minimally invasive surgery may have advantages in patients requiring distal or subtotal resection, a total Gastrectomy requires an esophagojejunal anastomosis. There is debate over the best method to perform this anastomosis and no technique appears to be superior. In this chapter, we describe our approach to open total Gastrectomy, highlighting the importance of lymph node dissection and a reliable esophagojejunal anastomotic technique.
-
Laparoscopic Gastrectomy for Gastric Cancer
Digestive Surgery, 2013Co-Authors: Han-kwang YangAbstract:Laparoscopic Gastrectomy for gastric cancer is rapidly becoming popular because of the technical developments and the accumulated data of laparoscopic surgery in gastric cancer patients. The aim of this review is to present the current body of evidence and to highlight controversial issues of laparoscopic Gastrectomy for gastric cancer. Laparoscopic distal Gastrectomy (LDG) provides better or comparable outcomes compared to conventional open distal Gastrectomy (ODG) in terms of short-term results. The long-term survival of LDG is expected to be comparable to that of ODG in early-stage gastric cancer, and an ongoing Korean multicenter randomized controlled trial (KLASS-01) will provide more clear evidence. Laparoscopic total Gastrectomy is still selectively performed compared to LDG, and there is still debate on the safety of the laparoscopic esophagojejunostomy technique. Laparoscopic pylorus-preserving Gastrectomy seems to be preferred for early gastric cancer in the middle third of the stomach in terms of functional advantages and comparable oncologic outcome. Evidence for LDG for advanced gastric cancer is still insufficient and the issue of lack of generalization still remains, even after ongoing multicenter randomized controlled trials have revealed clinical evidence. Laparoscopic sentinel node navigation surgery is still experimental and the surgical procedure has yet to be standardized. Robotic Gastrectomy is feasible for early gastric cancer in terms of similar outcome, but is much more expensive in comparison to laparoscopic surgery. Its benefit over the conventional laparoscopic Gastrectomy has not yet been proven.
Ninh T Nguyen - One of the best experts on this subject based on the ideXlab platform.
-
laparoscopic sleeve Gastrectomy leads the u s utilization of bariatric surgery at academic medical centers
Surgery for Obesity and Related Diseases, 2015Co-Authors: Esteban J Varela, Ninh T NguyenAbstract:Abstract Background Analysis of a recent single state bariatric surgery registry revealed that laparoscopic sleeve Gastrectomy was the most common bariatric procedure starting in 2012. The objective of this study was to examine the trend in utilization of laparoscopic sleeve Gastrectomy performed at academic medical centers in the United States. Methods Using ICD-9 diagnosis and procedure codes, clinical data obtained from the University HealthSystem Consortium database for all bariatric procedures performed for the treatment of severe obesity between October 1, 2011, and June 30, 2014. Quarterly trends in utilization for the 4 most commonly performed bariatric operations were examined, and comparisons between procedures were performed. Results A total of 54,953 bariatric procedures were performed. Utilization of laparoscopic sleeve Gastrectomy increased from 23.7% of all bariatric procedures during the fourth quarter of 2011 to 60.7% during the second quarter of 2014 while laparoscopic gastric bypass decreased from 62.2% to 37.0%, respectively. Utilization of laparoscopic sleeve Gastrectomy surpassed that of laparoscopic gastric bypass in the second quarter of 2013 (50.6% versus 45.8%). During the same time period, utilization of open gastric bypass fell from 6.6% to 1.5%, and the use of laparoscopic adjustable gastric banding decreased from 7.5% to .8%. Conclusions Within the context of U.S. academic medical centers, there has been a significant increase in the utilization of laparoscopic sleeve Gastrectomy, which has surpassed laparoscopic gastric bypass utilization since 2013. Laparoscopic sleeve Gastrectomy is now the most commonly performed bariatric procedure at the national level within academic centers.
-
use and outcomes of laparoscopic sleeve Gastrectomy vs laparoscopic gastric bypass analysis of the american college of surgeons nsqip
Journal of The American College of Surgeons, 2015Co-Authors: Monica T Young, Alana Gebhart, Michael J Phelan, Ninh T NguyenAbstract:Background Laparoscopic sleeve Gastrectomy is gaining popularity in the United States. However, few studies have examined outcomes of sleeve Gastrectomy compared with those of the "gold standard" bariatric operation: Roux-en-Y gastric bypass. Study Design Using the American College of Surgeons National Surgical Quality Improvement Program database, clinical data were obtained for all patients who underwent laparoscopic sleeve Gastrectomy or laparoscopic gastric bypass between 2010 and 2011. Main outcomes measures were risk-adjusted 30-day serious morbidity and mortality. Results We analyzed 24,117 patients who underwent laparoscopic sleeve Gastrectomy or laparoscopic gastric bypass for the treatment of morbid obesity. Gastric bypass comprised 79.5% of cases and sleeve Gastrectomy comprised 20.5%; the proportion of sleeve Gastrectomy cases increased from 14.6% in 2010 to 25.8% in 2011. On univariate analysis, sleeve Gastrectomy had a shorter mean operative time (101 vs 133 minutes, p Conclusions Use of laparoscopic sleeve Gastrectomy is increasing on a national level. Compared with laparoscopic gastric bypass, laparoscopic sleeve Gastrectomy is associated with lower 30-day risk-adjusted serious morbidity and equivalent 30-day mortality.
-
single laparoscopic incision transabdominal surgery sleeve Gastrectomy
Obesity Surgery, 2008Co-Authors: Kevin M Reavis, Marcelo W Hinojosa, Brian R Smith, Ninh T NguyenAbstract:Laparoscopic sleeve Gastrectomy has recently been added to the list of appropriate weight loss operations presently performed by bariatric surgeons. The sleeve Gastrectomy is routinely performed using five and up to seven laparoscopic trocars with enlargement of one of the trocar sites for extraction of the gastric specimen. We describe a case of laparoscopic sleeve Gastrectomy performed through a single laparoscopic incision.
Kyo Young Song - One of the best experts on this subject based on the ideXlab platform.
-
effect of laparoscopic distal Gastrectomy vs open distal Gastrectomy on long term survival among patients with stage i gastric cancer the klass 01 randomized clinical trial
JAMA Oncology, 2019Co-Authors: Han-kwang Yang, Kyo Young Song, Do Joong Park, Woo Jin HyungAbstract:Importance Laparoscopic distal Gastrectomy is gaining popularity over open distal Gastrectomy for gastric cancer because of better early postoperative outcomes. However, to our knowledge, no studies have proved whether laparoscopic distal Gastrectomy is oncologically equivalent to open distal Gastrectomy. Objective To examine whether the long-term survival among patients with stage I gastric cancer undergoing laparoscopic distal Gastrectomy is noninferior to that among patients undergoing open distal Gastrectomy. Design The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group, which includes 15 surgeons from 13 institutes, conducted a phase 3, multicenter, open-label, noninferiority, prospective randomized clinical trial (KLASS-01) of patients with histologically proven, preoperative clinical stage I gastric adenocarcinoma from January 5, 2006, to August 23, 2010. Survival and recurrence status of the patients was determined in December 2016. Interventions Patients were randomly assigned (1:1) to laparoscopic distal Gastrectomy (n = 705) or open distal Gastrectomy (n = 711). Of these patients, 85 received a surgical approach opposite the one to which they were randomized (63 randomized to the open surgery group and 22 to the laparoscopic group). Main Outcomes and Measures Difference in 5-year overall survival between the laparoscopic and open distal Gastrectomy groups. The noninferiority margin was prespecified as −5% (corresponding hazard ratio of 1.54), with an assumed survival of 90% after 5 years in the open surgery group. Results Among the 1416 patients (mean [SD] age, 57.3 [11.1] years; 940 [66.4%] male) included in the study, the 5-year overall survival rates were 94.2% in the laparoscopic group and 93.3% in the open surgery group (log-rankP = .64). Intention-to-treat analysis confirmed the noninferiority of the laparoscopic approach compared with the open approach (difference, 0.9 percentage points; 1-sided 97.5% CI, −1.6 to infinity). The 5-year cancer-specific survival rates were similar between the 2 groups (97.1% in the laparoscopic group and 97.2% in the open surgery group, log-rankP = .91; difference, −0.03 percentage points; 1-sided 97.5% CI, −1.8 to infinity). Per-protocol analysis results were consistent with the intention-to-treat results for overall and cancer-specific survival rates. Conclusions and Relevance The KLASS-01 trial revealed similar overall and cancer-specific survival rates between patients receiving laparoscopic and open distal Gastrectomy. Laparoscopic distal Gastrectomy is an oncologically safe alternative to open surgery for stage I gastric cancer. Trial Registration ClinicalTrials.gov identifier:NCT00452751
-
decreased morbidity of laparoscopic distal Gastrectomy compared with open distal Gastrectomy for stage i gastric cancer short term outcomes from a multicenter randomized controlled trial klass 01
Annals of Surgery, 2016Co-Authors: Woo Jin Hyung, Han-kwang Yang, Do Joong Park, Kyo Young SongAbstract:Objective:To determine the safety of laparoscopy-assisted distal Gastrectomy (LADG) compared with open distal Gastrectomy (ODG) in patients with clinical stage I gastric cancer in Korea.Background:There is still a lack of large-scale, multicenter randomized trials regarding the safety of LADG.Method
-
Is totally laparoscopic Gastrectomy less invasive than laparoscopy-assisted Gastrectomy?: prospective, multicenter study.
Journal of Gastrointestinal Surgery, 2008Co-Authors: Kyo Young Song, Cho Hyun Park, Han Chol Kang, Seung Man Park, Hyung Min ChinAbstract:Background Laparoscopic surgery has been adopted for the treatment of gastric cancer, and many reports have confirmed its favorable outcomes. Most surgeons prefer to laparoscopy-assisted Gastrectomy using minilaparotomy rather than totally laparoscopic procedures because of technical difficulties of intracorporeal anastomosis. We conducted this study to compare laparoscopy-assisted distal Gastrectomy with totally laparoscopic distal Gastrectomy. In addition, laparoscopic procedures were compared with open distal Gastrectomy.
