Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?

Table 1 Clinical outcomes of endoscopic submucosal dissection for remnant gastric cancer

Ref.	Initial surgery	No. of ESD lesions	Suture line/ anastomo-sis	En bloc resection	Complete resection	Curative resection	Complications		5-yr OS
							Bleeding	Perforation
Takenaka et al[35], 2008	DG	31	12	96.8%	NA	74.2%	0	13%	NA
Hirasaki et al[36], 2008	DG	17	NA	100%	82.4%	82.4%	17.6%	0	NA
Lee et al[37], 2010	DG	13	6	100%	92%	85%	0	0	NA
Hoteya et al[38], 2010	Gastrectomy or EG	40	NA	NA	95.0%	80%	5.0%	2.5%	NA
Nishide et al[39], 2012	Gastrectomy or EG	62	29	95%	85%	85%	8%	18%	NA
Nonaka et al[40], 201 3	PG/DG/PPG	139	47	94%	85%	78%	1.4%	1.4%	87.3%
Tanaka et al[41], 2014	DG	33	11	100%	93.9%	93.9%	3.0%	9.1%	NA
Ojima et al[42], 2014	DG/PG/ Gastric conduit/ Partial gastrectomy	49	8	100%	85.7%	81.6%	2%	12.2%	NA
Yamashina et al[43], 2015	DG/PG	42	NA	NA	NA	NA	0	4.8%	81.8%
Ojima et al[44], 2016	PG/DG/PD/EG	34	NA	100	85.3	NA	NA	NA	99.5%
Lee et al[45], 2016	DG	18	9	88.9%	91.7%	91.7%	0	5.6%	NA
Song et al[46], 2017	PD/DG	31	4	90%	77%	71%	6%	3%	NA
Fukui et al[30], 2018	DG	80	NA	NA	NA	68%	NA	NA	NA
Yabuuchi et al[47], 2019	PG/DG/PPG	157	73	95.5%	84.7%	70.9%	9.6%	11.5%	88.4%
Nomura et al[48], 2018	PG/DG/PPG	138	64	NA	89.1%	77.5%	4.3%	2.2%	NA

PG: Proximal Gastrectomy; DG: Distal Gastrectomy; PPG: Pylorus Preserving Gastrectomy; EG: Esophagectomy; PD: Pancreaticoduodenectomy; NA: Not applicable; OS: Overall survival; ESD: endoscopic submucosal dissection.

Table 2 Clinical outcomes of subtotal gastrectomy for remnant gastric cancer

Ref.	Type of procedure	No. of patients	Operating time (min)	Blood loss (mL)	Retrieved lymph node	Hospital stay	Complica-tions	Follow-up (mo)	Recurrence/5-yr OS
Hosokawa et al[52], 2014	SG	13	174 ± 53.0	381 ± 372	NA	17.8 ± 8.7	23.10%	99.2	0
	TG	22	200 ± 59.8	597 ± 489	NA	18.6 ± 7.1	27.30%	57.2	1
Irino et al[53], 2014	SG	24	NA	NA	18.5 (0–46)	NA	29%	36	94.10%
	TG	42	NA	NA	16.5 (3–86)	NA	14%	32	67.30%

NA: Not applicable; OS: Overall survival.

Table 3 Clinical outcomes of laparoscopic surgery for remnant gastric cancer

Ref.	Type of procedure	No. of patients	Conver-sion to open surgery	Operative time (min)	Blood loss	Retrieved lymph-node	Postopera-tive hospital stay	Complica-tions	Follow-up (mo)	5-yr OS
Nagai et al[60], 2014	LG	12	0	362.3 ± 68.4	68.5 ± 62 g	23.7 ± 10.7	11.3 ± 2.8	0	39.1 ± 20.5	77.80%
	OG	10	NA	270.5 ± 94.9	746.3 ± 577.1 g	15.7 ± 7.6	24.9 ± 10	20%	62.7 ± 39.8	72.90%
Son et al[61], 2015	LG	17	47.10%	234.4 ± 65.2	227.6 ± 245.0 mL	18.8 ± 12.3	9.3 ± 3.2	35.20%	23.6	66.70%
	OG	17	NA	170.0 ± 39.5	184.1 ± 123.1 mL	22.3 ± 14.4	9.3 ± 3.1	29.40%	37.3	60.30%
Kwon et al[62], 2014	LG	18a	5.60%	266.2 ± 77.2	182.2 ± 188.7 mL	8	6	33.30%	25.2	94.90%
	OG	58	NA	203.3 ± 52.2	193.1 ± 227.6 mL	7	9	44.80%		100%
Kim et al[63], 2014	LG	17	0	197.2 ± 60.6	NA	NA	11.1 ± 8.7	30%	NA	NA
	OG	50	NA	149.3 ± 46.9	NA	NA	13.8 ± 9.4	23.50%	NA	NA
Tsunoda et al[64], 2016	LG	10	0	324.5 ± 42.8	55 g	22.4 ± 15.8	12.5 ± 2.9	10	NA	NA
	OG	6	NA	289	893 g	7	24	33.30%	NA	NA
Luo et al [65], 2015	LG	9	0	221.1 ± 19.5	105.5 ± 35.04 mL	16.2 ± 3	NA	11.10%	NA	NA
	OG	9	NA	212.9 ± 14.3	147.7 ± 41.92 mL	16.7 ± 3.3	NA	22.20%	NA	NA
Booka et al[66], 2019	LG	8	25%	307.5 ± 56.0	135.5 ± 181.2 mL	8.8 ± 4.6	10.6 ± 3.7	37.50%	NA	NA
	OG	23	NA	295.8 ± 81.7	568.3 ± 446.4 mL	6.0 ± 6.9	21.3 ± 37.3	26.10%	NA	NA
Nakaji et al[67], 2019	LG	4	0	455	158 mL	15	15	50%	NA	94%
	OG	18	NA	293	625 mL	11	16	27.80%	NA
Otsuka et al[68], 2019	LG	7	0	364 ± 95	70 ± 71 g	22 ± 13	13 ± 5	28.60%	NA	NA
	OG	20	NA	309 ± 104	1066 ± 1428 g	12 ± 9	27 ± 21	50%	NA	NA
Kaihara et al[69], 2019	LG	6	17%	310.5	50 mL	7	9	50%	21	88%
	OG	15	NA	263	465 mL	3	9	33%		60.60%

^aTen laparoscopic gastrectomy, eight robotic gastrectomy. LG: Laparoscopic Gastrectomy; OG; Open Gastrectomy; NA: Not applicable; OS: Overall survival.