Laparoscopic-assisted vs open transhiatal gastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction: A retrospective cohort study

Table 1 Clinicopathological characteristics for patients in two cohorts

Characteristics	LTG, n = 382	OTG, n = 196	P value
Age in yr	64 (58, 69)	63 (59, 69)	0.816a
Sex, n (%)
Female	44 (11.5)	22 (11.2)	1.000
Male	338 (88.5)	174 (88.8)
BMI (kg/m2)	24.45 (22.10, 26.70)	24.40 (22.50, 27.25)	0.389a
Smoking history, n (%)			0.635
No	280 (73.3)	148 (75.5)
Yes	102 (26.7)	48 (24.5)
Drinking history, n (%)			0.773
No	212 (55.5)	112 (57.1)
Yes	170 (44.5)	84 (42.9)
ASA, n (%)
1	201 (52.6)	100 (51.0)	0.396
2	164 (42.9)	82 (41.8)
3	17 (4.5)	14 (7.1)
Tumor size (cm)	3.49 ± 1.60	3.69 ± 1.62	0.161
Grade, n (%)			0.267
1-2	132 (34.6)	58 (29.6)
3-4	250 (65.4)	138 (70.4)
T stage, n (%)			0.860
T1-T2	129 (33.8)	64 (32.7)
T3-4a	253 (66.2)	132 (67.3)
N stage, n (%)			0.602
N0	168 (44.0)	81 (41.3)
N1-N3	214 (56.0)	115 (58.7)
TNM stage, n (%)			0.544
I	107 (28.0)	49 (25.0)
II	120 (31.4)	70 (35.7)
III	155 (40.6)	77 (39.3)

^aMann-Whitney U test. ASA: American Society of Anesthesiologists; BMI: Body mass index; LTG: Laparoscopic-assisted transhiatal gastrectomy; OTG: Open transhiatal gastrectomy.

Table 2 Perioperative outcomes (mean ± SD)/median (interquartile range)

	LTG, n = 382	OTG, n = 196	P value
Operation time in min	230.14 ± 58.92	198.4 ± 56.76	< 0.001
Blood loss in m	200.42 ± 304.34	275.77 ± 384.72	0.010
Length of abdominal incision in cm	9.66 ± 1.73	18.12 ± 3.92	< 0.001
Length of proximal margin in cm	1.15 ± 0.72	1.16 ± 0.77	0.986
R-status, n (%)			0.879
R0	380 (99.5)	194 (99.0)
R1/2	2 (0.5)	2 (1.0)
Number of harvested LNs	28.81 ± 12.16	26.20 ± 12.23	0.015
Number of positive LNs	3.72 ± 6.33	3.61 ± 5.30	0.842
Time to liquid diet in d	3.65 ± 2.56	4.62 ± 2.49	< 0.001
Time to first flatus or defecation in d	3.87 ± 2.17	5.62 ± 2.35	< 0.001
Time to ambulation in d	2.93 ± 2.04	4.13 ± 2.55	< 0.001
Postoperative hospitalization in d	9 (8, 11)	10 (9, 12)	< 0.001a
Postoperative complication, n (%)	19 (5.0)	9 (4.6)	0.840
Clavien–Dindo ≥ IIIa	18 (4.7)	8 (4.1)	0.729
Anastomotic leakage	13 (3.4)	5 (2.6)	0.577
Abdominal abscess	2 (0.5)	1 (0.5)	1.000
Anastomotic stenosis	2 (0.5)	1 (0.5)	1.000
Pneumonia	0	1 (0.5)	0.339b
Arrhythmia	1 (0.3)	0	1.000b
Wound infection	1 (0.3)	1 (0.5)	1.000b
Mortality	0	0

^aMann-Whitney U test.

^bFisher’s test.

LNs: Lymph nodes; LTG: Laparoscopic-assisted transhiatal gastrectomy; OTG: Open transhiatal gastrectomy.

Table 3 Patterns of recurrence

	LTG, n = 382	OTG, n = 196	P value
Recurrence, n (%)
No	333 (87.2)	175 (89.3)	0.547
Yes	49 (12.8)	21 (10.7)
Liver metastasis, n (%)
No	372 (97.4)	193 (98.5)	0.590
Yes	10 (2.6)	3 (1.5)
Lung metastasis, n (%)
No	376 (98.4)	192 (98.0)	0.941
Yes	6 (1.6)	4 (2.0)
Bone metastasis, n (%)
No	377 (98.7)	193 (98.5)	1.000
Yes	5 (1.3)	3 (1.5)
Brain metastasis, n (%)
No	380 (99.5)	193 (98.5)	0.445
Yes	2 (0.5)	3 (1.5)
Pancreas metastasis, n (%)
No	381 (99.7)	194 (99.0)	0.555
Yes	1 (0.3)	2 (1.0)
Anastomotic recurrence, n (%)
No	369 (96.6)	189 (96.4)	1.000
Yes	13 (3.4)	7 (3.6)
Peritoneal dissemination, n (%)
No	377 (98.7)	196 (100.0)	0.257
Yes	5 (1.3)	0 (0.0)
Lymph node metastasis, n (%)
No	377 (98.7)	196 (100.0)	0.257
Yes	5 (1.3)	0 (0.0)
Others, n (%)
No	378 (99.0)	196 (100.0)	0.364
Yes	4 (1.0)	0 (0.0)

LTG: Laparoscopic-assisted transhiatal gastrectomy; OTG: Open transhiatal gastrectomy.