Yonsei Med J.  2016 Sep;57(5):1294-1297. 10.3349/ymj.2016.57.5.1294.

When Eastern Surgeons Meet Western Patients: A Pilot Study of Gastrectomy with Lymphadenectomy in Caucasian Patients at a Single Korean Institute

Affiliations
  • 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. sunghoonn@yuhs.ac
  • 2Department of Gastric Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
  • 3Department of Gastrointestinal Surgery, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, China.
  • 4Brain Korea 21 PLUS Project for Medical Science, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea.

Abstract

East Asian surgeons generally report lower morbidity and mortality rates for gastrectomy with D2 lymphadenectomy than do surgeons in Western countries; however, the disparity remains unexplained. The aim of this article was to determine the feasibility and safety regarding cases in which East Asian surgeons perform such procedures in Caucasian patients (CPs). Twelve CPs underwent gastrectomy with lymphadenectomy for gastric cancer at Yonsei University Severance Hospital, Seoul, Korea between June 2011 and April 2014. Procedures performed included total gastrectomy (7 of 12, 58%), distal gastrectomy (4 of 12, 33%), and completion total gastrectomy (1 of 12, 8%). Nine patients (75%) underwent D2 lymphadenectomy, and D1+ lymphadenectomy was performed in three others (25%). In four patients (33%), combined resections were carried out. The median values of surgical parameters were as follows: operative time, 266.5 min (range, 120-586 min); estimated blood loss, 90 mL (range, 37-350 mL); retrieved lymph node count, 37.5 (range, 22-63); and postoperative hospital stay, 13.7 days (range, 5-63 days). No mortality was encountered, although two patients (17%) experienced complications (both Clavien-Dindo classification grade IIIa anastomotic leakages), which were successfully managed by conservative treatment. In the hands of East Asian surgeons, mortality and short-term morbidity appears to be acceptably low in CPs subjected to gastrectomy with lymphadenectomy for gastric cancer.

Keyword

Gastric cancer; gastrectomy; lymphadenectomy; Caucasians

MeSH Terms

Adult
Aged
*European Continental Ancestry Group
Female
*Gastrectomy/adverse effects
Humans
Length of Stay
*Lymph Node Excision/adverse effects
Male
Middle Aged
Operative Time
*Patients
Pilot Projects
Republic of Korea
Safety
Stomach Neoplasms/pathology/*surgery
*Surgeons
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