KOBV Portal

1

Online Resource

Pattern of lymph node metastases in gastric cancer: a side-study of the multicenter LOGICA-trial

de Jongh, Cas ; Triemstra, Lianne ; van der Veen, Arjen ; [et al.]

Springer Science and Business Media LLC ; 2022

In: Gastric Cancer Vol. 25, No. 6 ( 2022-11), p. 1060-1072

add to watchlist on the watchlist

Details

In: Gastric Cancer, Springer Science and Business Media LLC, Vol. 25, No. 6 ( 2022-11), p. 1060-1072

Abstract: The relation between gastric cancer characteristics and lymph node (LN) metastatic patterns is not fully clear, especially following neoadjuvant chemotherapy (NAC). This study analyzed nodal metastatic patterns. Methods Individual LN stations were analyzed for all patients from the LOGICA-trial, a Dutch multicenter randomized trial comparing laparoscopic versus open D2-gastrectomy for gastric cancer. The pattern of metastases per LN station was related to tumor location, cT-stage, Lauren classification and NAC. Results Between 2015–2018, 212 patients underwent D2-gastrectomy, of whom 158 (75%) received NAC. LN metastases were present in 120 patients (57%). Proximal tumors metastasized predominantly to proximal LN stations (no. 1, 2, 7 and 9; p 〈 0.05), and distal tumors to distal LN stations (no. 5, 6 and 8; OR 〉 1, p 〉 0.05). However, distal tumors also metastasized to proximal LN stations, and vice versa. Despite NAC, each LN station (no. 1–9, 11 and 12a) showed metastases, regardless of tumor location, cT-stage, histological subtype and NAC treatment, including station 12a for cT1N0-tumors. LN metastases were present more frequently in diffuse versus intestinal tumors (66% versus 52%; p = 0,048), but not for cT3–4- versus cT1–2-stage (59% versus 51%; p = 0.259). However, the pattern of LN metastases was similar for these subgroups. Conclusions The extent of lymphadenectomy cannot be reduced after NAC for gastric cancer. Although the pattern of LN metastases is related to tumor location, all LN stations contained metastases regardless of tumor location, cT-stage (including cT1N0-tumors), histological subtype, or NAC treatment. Therefore, D2-lymphadenectomy should be routinely performed during gastrectomy in Western patients.

Type of Medium: Online Resource

ISSN: 1436-3291 , 1436-3305

URL: Article

DOI: 10.1007/s10120-022-01329-2

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 1481763-9

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

2

Online Resource

Trends in Distal Esophageal and Gastroesophageal Junction Cancer Care : The Dutch Nationwide Ivory Study

Kalff, Marianne C. ; van Berge Henegouwen, Mark I. ; Baas, Peter C. ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2023

In: Annals of Surgery Vol. 277, No. 4 ( 2023-04), p. 619-628

add to watchlist on the watchlist

Details

In: Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 277, No. 4 ( 2023-04), p. 619-628

Abstract: This study evaluated the nationwide trends in care and accompanied postoperative outcomes for patients with distal esophageal and gastro-esophageal junction cancer. Summary of Background Data: The introduction of transthoracic esophagectomy, minimally invasive surgery, and neo-adjuvant chemo(radio)therapy changed care for patients with esophageal cancer. Methods: Patients after elective transthoracic and transhiatal esophagectomy for distal esophageal or gastroesophageal junction carcinoma in the Netherlands between 2007–2016 were included. The primary aim was to evaluate trends in both care and postoperative outcomes for the included patients. Additionally, postoperative outcomes after transthoracic and tran-shiatal esophagectomy were compared, stratified by time periods. Results: Among 4712 patients included, 74% had distal esophageal tumors and 87% had adenocarcinomas. Between 2007 and 2016, the proportion of transthoracic esophagectomy increased from 41% to 81%, and neo-adjuvant treatment and minimally invasive esophagectomy increased from 31% to 96%, and from 7% to 80%, respectively. Over this 10-year period, postoperative outcomes improved: postoperative morbidity decreased from 66.6% to 61.8% ( P = 0.001), R0 resection rate increased from 90.0% to 96.5% (P 〈 0.001), median lymph node harvest increased from 15 to 19 ( P 〈 0.001), and median survival increased from 35 to 41 months ( P = 0.027). Conclusion: In this nationwide cohort, a transition towards more neo-adju-vant treatment, transthoracic esophagectomy and minimally invasive surgery was observed over a 10-year period, accompanied by decreased postoperative morbidity, improved surgical radicality and lymph node harvest, and improved survival.

Type of Medium: Online Resource

ISSN: 0003-4932

URL: Article

DOI: 10.1097/SLA.0000000000005292

RVK:

XA 23900

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2023

detail.hit.zdb_id: 2002200-1

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

3

Online Resource

Body Composition Is a Predictor for Postoperative Complications After Gastrectomy for Gastric Cancer: a Prospective Side Study of the LOGICA Trial

Tweed, Thaís T. T. ; van der Veen, Arjen ; Tummers, Stan ; [et al.]

Springer Science and Business Media LLC ; 2022

In: Journal of Gastrointestinal Surgery Vol. 26, No. 7 ( 2022-07), p. 1373-1387

add to watchlist on the watchlist

Details

In: Journal of Gastrointestinal Surgery, Springer Science and Business Media LLC, Vol. 26, No. 7 ( 2022-07), p. 1373-1387

Abstract: There is a lack of prospective studies evaluating the effects of body composition on postoperative complications after gastrectomy in a Western population with predominantly advanced gastric cancer. Methods This is a prospective side study of the LOGICA trial, a multicenter randomized trial on laparoscopic versus open gastrectomy for gastric cancer. Trial patients who received preoperative chemotherapy followed by gastrectomy with an available preoperative restaging abdominal computed tomography (CT) scan were included. The CT scan was used to calculate the mass (M) and radiation attenuation (RA) of skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). These variables were expressed as Z -scores, depicting how many standard deviations each patient’s CT value differs from the sex-specific study sample mean. Primary outcome was the association of each Z -score with the occurrence of a major postoperative complication (Clavien-Dindo grade ≥ 3b). Results From 2015 to 2018, a total of 112 patients were included. A major postoperative complication occurred in 9 patients (8%). A high SM-M Z -score was associated with a lower risk of major postoperative complications (RR 0.47, 95% CI 0.28–0.78, p = 0.004). Furthermore, high VAT-RA Z -scores and SAT-RA Z -scores were associated with a higher risk of major postoperative complications (RR 2.82, 95% CI 1.52–5.23, p = 0.001 and RR 1.95, 95% CI 1.14–3.34, p = 0.015, respectively). VAT-M, SAT-M, and SM-RA Z -scores showed no significant associations. Conclusion Preoperative low skeletal muscle mass and high visceral and subcutaneous adipose tissue radiation attenuation (indicating fat depleted of triglycerides) were associated with a higher risk of developing a major postoperative complication in patients treated with preoperative chemotherapy followed by gastrectomy.

Type of Medium: Online Resource

ISSN: 1091-255X , 1873-4626

URL: Article

DOI: 10.1007/s11605-022-05321-0

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 2057634-1

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

4

Online Resource

Cost-effectiveness of Laparoscopic vs Open Gastrectomy for Gastric Cancer : An Economic Evaluation Alongside a Randomized Clinical Trial

van der Veen, Arjen ; van der Meulen, Miriam P. ; Seesing, Maarten F. J. ; [et al.]

American Medical Association (AMA) ; 2023

In: JAMA Surgery Vol. 158, No. 2 ( 2023-02-01), p. 120-

add to watchlist on the watchlist

Details

In: JAMA Surgery, American Medical Association (AMA), Vol. 158, No. 2 ( 2023-02-01), p. 120-

Abstract: Laparoscopic gastrectomy is rapidly being adopted worldwide as an alternative to open gastrectomy to treat gastric cancer. However, laparoscopic gastrectomy might be more expensive as a result of longer operating times and more expensive surgical materials. To date, the cost-effectiveness of both procedures has not been prospectively evaluated in a randomized clinical trial. Objective To evaluate the cost-effectiveness of laparoscopic compared with open gastrectomy. Design, Setting, and Participants In this multicenter randomized clinical trial of patients undergoing total or distal gastrectomy in 10 Dutch tertiary referral centers, cost-effectiveness data were collected alongside a multicenter randomized clinical trial on laparoscopic vs open gastrectomy for resectable gastric adenocarcinoma (cT1-4aN0-3bM0). A modified societal perspective and 1-year time horizon were used. Costs were calculated on the individual patient level by using hospital registry data and medical consumption and productivity loss questionnaires. The unit costs of laparoscopic and open gastrectomy were calculated bottom-up. Quality-adjusted life-years (QALYs) were calculated with the EuroQol 5-dimension questionnaire, in which a value of 0 indicates death and 1 indicates perfect health. Missing questionnaire data were imputed with multiple imputation. Bootstrapping was performed to estimate the uncertainty surrounding the cost-effectiveness. The study was conducted from March 17, 2015, to August 20, 2018. Data analyses were performed between September 1, 2020, and November 17, 2021. Interventions Laparoscopic vs open gastrectomy. Main Outcomes and Measures Evaluations in this cost-effectiveness analysis included total costs and QALYs. Results Between 2015 and 2018, 227 patients were included. Mean (SD) age was 67.5 (11.7) years, and 140 were male (61.7%). Unit costs for initial surgery were calculated to be €8124 (US $8087) for laparoscopic total gastrectomy, €7353 (US $7320) for laparoscopic distal gastrectomy, €6584 (US $6554) for open total gastrectomy, and €5893 (US $5866) for open distal gastrectomy. Mean total costs after 1-year follow-up were €26 084 (US $25 965) in the laparoscopic group and €25 332 (US $25 216) in the open group (difference, €752 [US $749; 3.0%]). Mean (SD) QALY contributions during 1 year were 0.665 (0.298) in the laparoscopic group and 0.686 (0.288) in the open group (difference, −0.021). Bootstrapping showed that these differences between treatment groups were relatively small compared with the uncertainty of the analysis. Conclusions and Relevance Although the laparoscopic gastrectomy itself was more expensive, after 1-year follow-up, results suggest that differences in both total costs and effectiveness were limited between laparoscopic and open gastrectomy. These results support centers’ choosing, based on their own preference, whether to (de)implement laparoscopic gastrectomy as an alternative to open gastrectomy.

Type of Medium: Online Resource

ISSN: 2168-6254

URL: Article

DOI: 10.1001/jamasurg.2022.6337

Language: English

Publisher: American Medical Association (AMA)

Publication Date: 2023

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

5

Online Resource

The Effect of Postoperative Complications After Minimally Invasive Esophagectomy on Long-term Survival : An International Multicenter Cohort Study

Fransen, Laura F. C. ; Berkelmans, Gijs H. K. ; Asti, Emanuele ; [et al.]

Ovid Technologies (Wolters Kluwer Health) ; 2021

In: Annals of Surgery Vol. 274, No. 6 ( 2021-12), p. e1129-e1137

add to watchlist on the watchlist

Details

In: Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 274, No. 6 ( 2021-12), p. e1129-e1137

Type of Medium: Online Resource

ISSN: 0003-4932 , 1528-1140

URL: Article

DOI: 10.1097/SLA.0000000000003772

RVK:

XA 23900

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2021

detail.hit.zdb_id: 2641023-0

detail.hit.zdb_id: 2002200-1

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

6

Online Resource

Distal Versus Total D2-Gastrectomy for Gastric Cancer: a Secondary Analysis of Surgical and Oncological Outcomes Including Quality of Life in the Multicenter Randomized LOGICA-Trial

de Jongh, Cas ; van der Veen, Arjen ; Brosens, Lodewijk A. A. ; [et al.]

Springer Science and Business Media LLC ; 2023

In: Journal of Gastrointestinal Surgery Vol. 27, No. 9 ( 2023-09), p. 1812-1824

add to watchlist on the watchlist

Details

In: Journal of Gastrointestinal Surgery, Springer Science and Business Media LLC, Vol. 27, No. 9 ( 2023-09), p. 1812-1824

Abstract: Distal gastrectomy (DG) for gastric cancer can cause less morbidity than total gastrectomy (TG), but may compromise radicality. No prospective studies administered neoadjuvant chemotherapy, and few assessed quality of life (QoL). Methods The multicenter LOGICA-trial randomized laparoscopic versus open D2-gastrectomy for resectable gastric adenocarcinoma (cT1–4aN0–3bM0) in 10 Dutch hospitals. This secondary LOGICA-analysis compared surgical and oncological outcomes after DG versus TG. DG was performed for non-proximal tumors if R0-resection was deemed achievable, TG for other tumors. Postoperative complications, mortality, hospitalization, radicality, nodal yield, 1-year survival, and EORTC-QoL-questionnaires were analyzed using Χ 2 -/Fisher’s exact tests and regression analyses. Results Between 2015 and 2018, 211 patients underwent DG ( n = 122) or TG ( n = 89), and 75% of patients underwent neoadjuvant chemotherapy. DG-patients were older, had more comorbidities, less diffuse type tumors, and lower cT-stage than TG-patients ( p 〈 0.05). DG-patients experienced fewer overall complications (34% versus 57%; p 〈 0.001), also after correcting for baseline differences, lower anastomotic leakage (3% versus 19%), pneumonia (4% versus 22%), atrial fibrillation (3% versus 14%), and Clavien-Dindo grading compared to TG-patients ( p 〈 0.05), and demonstrated shorter median hospital stay (6 versus 8 days; p 〈 0.001). QoL was better after DG (statistically significant and clinically relevant) in most 1-year postoperative time points. DG-patients showed 98% R0-resections, and similar 30-/90-day mortality, nodal yield (28 versus 30 nodes; p = 0.490), and 1-year survival after correcting for baseline differences ( p = 0.084) compared to TG-patients. Conclusions If oncologically feasible, DG should be preferred over TG due to less complications, faster postoperative recovery, and better QoL while achieving equivalent oncological effectiveness. Mini-abstract Distal D2-gastrectomy for gastric cancer resulted in less complications, shorter hospitalization, quicker recovery and better quality of life compared to total D2-gastrectomy, whereas radicality, nodal yield and survival were similar.

Type of Medium: Online Resource

ISSN: 1091-255X , 1873-4626

URL: Article

DOI: 10.1007/s11605-023-05683-z

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2023

detail.hit.zdb_id: 2057634-1

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

7

Online Resource

Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA): A Multicenter Randomized Clinical Trial

van der Veen, Arjen ; Brenkman, Hylke J. F. ; Seesing, Maarten F. J. ; [et al.]

American Society of Clinical Oncology (ASCO) ; 2021

In: Journal of Clinical Oncology Vol. 39, No. 9 ( 2021-03-20), p. 978-989

add to watchlist on the watchlist

Details

In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 9 ( 2021-03-20), p. 978-989

Abstract: The oncological efficacy and safety of laparoscopic gastrectomy are under debate for the Western population with predominantly advanced gastric cancer undergoing multimodality treatment. METHODS In 10 experienced upper GI centers in the Netherlands, patients with resectable (cT1-4aN0-3bM0) gastric adenocarcinoma were randomly assigned to either laparoscopic or open gastrectomy. No masking was performed. The primary outcome was hospital stay. Analyses were performed by intention to treat. It was hypothesized that laparoscopic gastrectomy leads to shorter hospital stay, less postoperative complications, and equal oncological outcomes. RESULTS Between 2015 and 2018, a total of 227 patients were randomly assigned to laparoscopic (n = 115) or open gastrectomy (n = 112). Preoperative chemotherapy was administered to 77 patients (67%) in the laparoscopic group and 87 patients (78%) in the open group. Median hospital stay was 7 days (interquartile range, 5-9) in both groups ( P = .34). Median blood loss was less in the laparoscopic group (150 v 300 mL, P 〈 .001), whereas mean operating time was longer (216 v 182 minutes, P 〈 .001). Both groups did not differ regarding postoperative complications (44% v 42%, P = .91), in-hospital mortality (4% v 7%, P = .40), 30-day readmission rate (9.6% v 9.1%, P = 1.00), R0 resection rate (95% v 95%, P = 1.00), median lymph node yield (29 v 29 nodes, P = .49), 1-year overall survival (76% v 78%, P = .74), and global health-related quality of life up to 1 year postoperatively (mean differences between + 1.5 and + 3.6 on a 1-100 scale; 95% CIs include zero). CONCLUSION Laparoscopic gastrectomy did not lead to a shorter hospital stay in this Western multicenter randomized trial of patients with predominantly advanced gastric cancer. Postoperative complications and oncological efficacy did not differ between laparoscopic gastrectomy and open gastrectomy.

Type of Medium: Online Resource

ISSN: 0732-183X , 1527-7755

URL: Article

DOI: 10.1200/JCO.20.01540

RVK:

XA 52760

RVK:

XA 10000

Language: English

Publisher: American Society of Clinical Oncology (ASCO)

Publication Date: 2021

detail.hit.zdb_id: 2005181-5

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

8

Online Resource

O200 10-YEAR FOLLOW-UP OF A RANDOMISED CONTROLLED TRIAL COMPARING NEOADJUVANT CHEMORADIOTHERAPY PLUS SURGERY VERSUS SURGERY ALONE FOR OESOPHAGEAL OR JUNCTIONAL CANCER (CROSS)

Eyck, Ben M ; van Lanschot, J Jan B ; Hulshof, Maarten C C M ; [et al.]

Oxford University Press (OUP) ; 2019

In: Diseases of the Esophagus Vol. 32, No. Supplement_2 ( 2019-11-23)

add to watchlist on the watchlist

Details

In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 32, No. Supplement_2 ( 2019-11-23)

Abstract: To report the long term results of the CROSS trial with a minimum follow-up of 10 years. Background Neoadjuvant chemoradiotherapy according to the Dutch randomised controlled ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) has become standard of care for patients with cancer of the oesophagus or oesophagogastric junction. Methods Patients with locally advanced resectable squamous cell carcinoma or adenocarcinoma of the oesophagus or oesophagogastric junction were randomised between neoadjuvant chemoradiotherapy (five weekly cycles of intravenous carboplatin [AUC 2 mg/mL per min] and intravenous paclitaxel [50 mg/m² of body-surface area] ) with concurrent 41.4 Gy radiotherapy given in 23 fractions of 1.8 Gy, 5 days per week) plus surgery versus surgery alone. Primary endpoint was overall survival, defined from date of randomisation to date of all-cause death or to last day of follow-up. Analysis was by intention-to-treat. Results Between March 2004 and 2008, eight centres enrolled 368 patients. Some 178 were analysed in the chemoradiotherapy plus surgery group and 188 in the surgery alone group. After a median follow-up for surviving patients of 146.6 months (IQR 133.5-156.6), median overall survival was 49.0 months (95%CI 34.7-76.6) in the neoadjuvant chemoradiotherapy plus surgery group compared to 25.1 months (95%CI 19.1-39.4) in the surgery alone group, which was significantly different (HR 0.71 [95%CI 0.55-0.90]; log-rank p=0·005). Ten-year overall survival was 38% (95%CI 31%-45%) in the neoadjuvant chemoradiotherapy followed by surgery group compared to 26% (95%CI 20%-33%) in the surgery alone group (HR 0.69 [95%CI 0.54-0.89] ). For patients with squamous cell carcinoma ten-year overall survival was 46% (95%CI 33%-64%) in the neoadjuvant chemoradiotherapy plus surgery group compared to 23% (95%CI 13%-40%) in the surgery alone group. For patients with adenocarcinoma ten-year overall survival was 36% (95%CI 29%-45%) in the neoadjuvant chemoradiotherapy plus surgery group compared to 26% (95%CI 20%-35%) in the surgery alone group. Conclusion Survival benefit of patients with locally advanced resectable squamous cell carcinoma or adenocarcinoma of the oesophagus or oesophagogastric junction receiving neoadjuvant chemoradiotherapy persists for at least 10 years compared to patients undergoing surgery alone.

Type of Medium: Online Resource

ISSN: 1442-2050

URL: Article

DOI: 10.1093/dote/doz092.200

Language: English

Publisher: Oxford University Press (OUP)

Publication Date: 2019

detail.hit.zdb_id: 2004949-3

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

9

Online Resource

Effect of direct oral feeding following minimally invasive esophagectomy on costs and quality of life

Pattamatta, Madhuri ; Fransen, Laura F. C. ; Dolmans-Zwartjes, Annemarie C. P. ; [et al.]

Informa UK Limited ; 2021

In: Journal of Medical Economics Vol. 24, No. 1 ( 2021-01-01), p. 54-60

add to watchlist on the watchlist

Details

In: Journal of Medical Economics, Informa UK Limited, Vol. 24, No. 1 ( 2021-01-01), p. 54-60

Type of Medium: Online Resource

ISSN: 1369-6998 , 1941-837X

URL: Article

DOI: 10.1080/13696998.2020.1859843

Language: English

Publisher: Informa UK Limited

Publication Date: 2021

detail.hit.zdb_id: 2156786-4

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

10

Online Resource

Pain and Opioid Consumption After Laparoscopic Versus Open Gastrectomy for Gastric Cancer: A Secondary Analysis of a Multicenter Randomized Clinical Trial (LOGICA-Trial)

van der Veen, Arjen ; Ramaekers, Mark ; Marsman, Marije ; [et al.]

Springer Science and Business Media LLC ; 2023

In: Journal of Gastrointestinal Surgery

add to watchlist on the watchlist

Details

In: Journal of Gastrointestinal Surgery, Springer Science and Business Media LLC

Abstract: Laparoscopic gastrectomy could reduce pain and opioid consumption, compared to open gastrectomy. However, it is difficult to judge the clinical relevance of this reduction, since these outcomes are reported in few randomized trials and in limited detail. Methods This secondary analysis of a multicenter randomized trial compared laparoscopic versus open gastrectomy for resectable gastric adenocarcinoma (cT1-4aN0-3bM0). Postoperative pain was analyzed by opioid consumption in oral morphine equivalents (OME, mg/day) at postoperative day (POD) 1–5, WHO analgesic steps, and Numeric Rating Scales (NRS, 0–10) at POD 1–10 and discharge. Regression and mixed model analyses were performed, with and without correction for epidural analgesia. Results Between 2015 and 2018, 115 patients in the laparoscopic group and 110 in the open group underwent surgery. Some 16 patients (14%) in the laparoscopic group and 73 patients (66%) in the open group received epidural analgesia. At POD 1–3, mean opioid consumption was 131, 118, and 53 mg OME lower in the laparoscopic group, compared to the open group, respectively (all p 〈 0.001). After correcting for epidural analgesia, these differences remained significant at POD 1–2 (47 mg OME, p = 0.002 and 69 mg OME, p 〈 0.001, respectively). At discharge, 27% of patients in the laparoscopic group and 43% patients in the open group used oral opioids ( p = 0.006). Mean highest daily pain scores were between 2 and 4 at all PODs, 〈 2 at discharge, and did not relevantly differ between treatment arms. Conclusion In this multicenter randomized trial, postoperative pain was comparable between laparoscopic and open gastrectomy. After laparoscopic gastrectomy, this was generally achieved without epidural analgesia and with fewer opioids. Trial Registration NCT02248519.

Type of Medium: Online Resource

ISSN: 1091-255X , 1873-4626

URL: Article

DOI: 10.1007/s11605-023-05728-3

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2023

detail.hit.zdb_id: 2057634-1

Bookmarklink

Library	Location	Call Number	Volume/Issue/Year	Availability

Others were also interested in ...

Online Resource

Open Access Request

Availability (electronic / print)

Link to publisher

Kooperativer Bibliotheksverbund

Berlin Brandenburg