Song QY, Li XG, Zhang LY, Wu D, Li S, Zhang BL, Xu ZY, Wu RLG, Guo X, Wang XX. Laparoscopic-assisted vs open transhiatal gastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction: A retrospective cohort study. World J Gastrointest Surg 2022; 14(4): 304-314 [PMID: 35664362 DOI: 10.4240/wjgs.v14.i4.304]
Corresponding Author of This Article
Xin-Xin Wang, MD, PhD, Assistant Professor, Chief Doctor, Department of General Surgery, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. 301wxx@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Apr 27, 2022; 14(4): 304-314 Published online Apr 27, 2022. doi: 10.4240/wjgs.v14.i4.304
Laparoscopic-assisted vs open transhiatal gastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction: A retrospective cohort study
Qi-Ying Song, Xiong-Guang Li, Li-Yu Zhang, Di Wu, Shuo Li, Ben-Long Zhang, Zi-Yao Xu, Ri-Li-Ge Wu, Xin Guo, Xin-Xin Wang
Qi-Ying Song, Li-Yu Zhang, Di Wu, Shuo Li, Ben-Long Zhang, Zi-Yao Xu, Medical School of Chinese People’s Liberation Army, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Xiong-Guang Li, School of Medicine, Nankai University, Tianjin 300071, China
Ri-Li-Ge Wu, Medical Big Data Research Center, Chinese PLA General Hospital, Beijing 100853, China
Xin Guo, Air Force Medical University Xijing Hospital, Xi’an 710000, Shaanxi Province, China
Xin-Xin Wang, Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Song QY, Li XG and Zhang LY contributed equally to this article; Song QY and Wang XX designed the experiment; Li XG and Zhang LY performed the experiment; Li S and Zhang BL collected data; Wu D and Xu ZY analyzed the data; Song QY and Wu RLG created the tables and figures based on the data; Song QY, Li XG and Zhang LY wrote the initial draft; Guo X and Wang XX modified the draft.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Chinese PLA General Hospital, No. S-2021-593-01.
Conflict-of-interest statement: All authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Xin Wang, MD, PhD, Assistant Professor, Chief Doctor, Department of General Surgery, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. 301wxx@sina.com
Received: December 7, 2021 Peer-review started: December 7, 2021 First decision: January 12, 2022 Revised: January 15, 2022 Accepted: March 26, 2022 Article in press: March 26, 2022 Published online: April 27, 2022 Processing time: 138 Days and 3.8 Hours
ARTICLE HIGHLIGHTS
Research background
Due to the lack of scientific evidence, the feasibility of laparoscopic-assist transhiatal gastrectomy (LTG) in patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is still controversial.
Research motivation
To compare the feasibility of LTG with the traditional open transhiatal gastrectomy (OTG) in patients with Siewert type II AEG.
Research objectives
We retrospectively evaluated and compared the short-term and long-term outcomes for patients with Siewert type II AEG treated with LTG and OTG and aimed to explore the feasibility of LTG treatment of Siewert type II AEG.
Research methods
We retrospectively evaluated 578 patients with Siewert type II AEG who have undergone LTG or OTG at the First Medical Center of the Chinese People’s Liberation Army General Hospital from January 2014 to December 2019. The short-term and long-term outcomes were compared between the LTG (n = 382) and OTG (n = 196) groups.
Research results
Compared with the OTG group, the LTG group had less surgical trauma and a faster recovery after surgery. No significant difference was present between the two groups regarding oncological safety. The 3-year overall survival and disease-free survival were better in the LTG group than those in the OTG group (88.2% vs 79.2%, P = 0.011; 79.7% vs 73.0%, P = 0.002, respectively). In the stratified analysis, both overall survival and disease-free survival were better in the LTG group than those in the OTG group for stage II/III patients (P < 0.05) but not for stage I patients.
Research conclusions
For patients with Siewert type II AEG, LTG is associated with better short-term outcomes and similar oncology safety. In addition, patients with advanced stage AEG may benefit more from LTG in the long-term outcomes.
Research perspectives
Well-designed multicenter prospective randomized controlled studies are still needed.
