| Title |
Minimally invasive surgery for gastric cancer: the American experience
|
|---|---|
| Published in |
Gastric Cancer, March 2016
|
| DOI | 10.1007/s10120-016-0605-5 |
| Pubmed ID | |
| Authors |
Erin K. Greenleaf, Susie X. Sun, Christopher S. Hollenbeak, Joyce Wong |
| Abstract |
Minimally invasive surgical techniques are increasingly being implemented in oncologic care. This study assesses the impact of minimally invasive surgery on oncologic and perioperative outcomes in the management of gastric cancer in the USA. From the American College of Surgeons and American Cancer Society National Cancer Data Base, we identified 6427 patients who underwent gastrectomy for cancer from 2010 to 2012. Treatment groups were categorized with an intention-to-treat paradigm as robotic, laparoscopic, and open surgery. Univariate and multivariate analyses were performed to estimate the impact of the surgical approach on oncologic and perioperative outcomes. Of patients undergoing definitive surgical intervention, 3.5 % (n = 223) underwent robotic gastrectomy, 23.1 % (n = 1487) underwent laparoscopic gastrectomy, and 73.4 % (n = 4717) underwent open surgery. Minimally invasive gastrectomy was more frequently performed on white (P = 0.018), privately insured patients (P = 0.049) treated at academic centers (P < 0.0001) in the eastern USA (P < 0.0001). After demographics, comorbidities, and tumor-related factors had been controlled for, patients who underwent laparoscopic gastrectomy had the postoperative length of stay decreased by 1.08 days (P < 0.0001) and greater odds of having at least 15 lymph nodes resected (odds ratio 1.16, P = 0.023). Use of robotic surgery did not have a statistically significant effect on the postoperative length of stay relative to open surgery (P = 0.222) but the patients so treated had greater odds of having at least 15 lymph nodes resected (odds ratio 1.51, P = 0.005). There were no differences in R0 resection rates or perioperative mortality on the basis of the surgical approach alone. These findings suggest that use of minimally invasive surgery for gastric cancer in the USA is impacting the adequacy of oncologic resection but is not yet having a clinically significant impact on perioperative outcomes relative to a conventional open approach. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Russia | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 33 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 18% |
| Student > Postgraduate | 4 | 12% |
| Student > Master | 3 | 9% |
| Student > Bachelor | 2 | 6% |
| Professor | 2 | 6% |
| Other | 5 | 15% |
| Unknown | 11 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 42% |
| Social Sciences | 2 | 6% |
| Nursing and Health Professions | 1 | 3% |
| Economics, Econometrics and Finance | 1 | 3% |
| Unspecified | 1 | 3% |
| Other | 3 | 9% |
| Unknown | 11 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 March 2017.
All research outputs
#15,450,375
of 22,959,818 outputs
Outputs from Gastric Cancer
#319
of 601 outputs
Outputs of similar age
#179,145
of 300,514 outputs
Outputs of similar age from Gastric Cancer
#4
of 9 outputs
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