Heijmans, Yara (2025) De toegevoegde waarde van intra-operatieve gastroscopie bij oncologische maagresecties ten behoeve van een R0-resectie Een retrospectief cohortonderzoek. thesis, Medicine.
Full text available on request.Abstract
Background: A gastrectomy, aimed at achieving an R0-resection, is the only curative treatment for gastric carcinoma. Accurate tumour localization and determination of the resection margin is crucial for achieving an R0 resection. Although researchers have proven the individual effectiveness of preoperative and intraoperative gastroscopy in determining these factors, they have not yet studied their combined use. Since 2019, this combined procedure has been routinely performed at the Medisch Centrum Leeuwarden. This study evaluates the added value of intraoperative gastroscopy, in combination with preoperative gastroscopy, in achieving an R0 resection. Methods: This retrospective cohort study included patients with gastric adenocarcinoma who underwent a gastrectomy between January 2015 and July 2024. Patients were divided into two groups: those who underwent only preoperative gastroscopy between 2015 and 2018 (group A), and those who underwent both preoperative and intraoperative gastroscopy between 2019 and July 2024 (group B). The primary outcome was the number of R0 resections, while the secondary outcome was the number of positive frozen sections. Potential confounders were also evaluated. Results: A total of 134 patients were included, with 61 patients in group A and 73 patients in group B. Although the rate of R0 resections was lower in group B compared to group A (82,2% vs. 90,2%), this difference was not statistically significant (p=0,221). The number of positive frozen sections was also similar between the groups (12,2% vs. 11,5%, p=1,00). This suggests that intraoperative gastroscopy does not significantly contribute to improve the outcome of the resection margins. The higher proportion of tumours located in the cardia in group B, although not statistically significant (p=0,058), may partly explain the lower rate of R0 resections observed in that group. Conclusion: Routine use of intraoperative gastroscopy, in combination with preoperative gastroscopy, does not significantly increase the likelihood of achieving an R0 resection. Future research, preferably prospective, on the effectiveness and specific indications of intra-operative gastroscopy, such as tumour localisation, is required.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Corporaal, Sietske |
| Faculty: | Medical Sciences |
| Date Deposited: | 27 Feb 2026 14:34 |
| Last Modified: | 27 Feb 2026 14:34 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3900 |
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