Gastric cancer confined to the muscularis propria: A possible candidate for laparoscopic surgery or adjuvant therapy

Kim, Chong Suk; Mok, Young Jae; Kim, Seungjoo; Kim, Ho Il

doi:10.1080/00365520410009302

Cited by 14 publications

(20 citation statements)

References 13 publications

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“…Clinical T1 cancer with perigastric LN involvement and serosa-negative gastric cancer without LN metastasis are also regarded as expanded indications for the use of MIS 4,5,13,14. These specific groups of patients could be treated in randomized controlled trials comparing different approaches.…”

Section: Indication Of Mis For Gastric Cancermentioning

confidence: 99%

“…Therefore, the results of treating advanced cancer with MIS should be investigated. Although there is no evidence and there are no guidelines that indicate that the use of MIS is appropriate, even for EGC, experienced surgeons have begun to treat patients with AGC using MIS, and have reported acceptable short-term outcomes 2,4,5,15,37,38. For some selected AGC cases, surgeons believe that this approach is not inferior to open conventional surgery in terms of the oncologic aspects.…”

Section: Mis For Agcmentioning

confidence: 99%

“…The proportion of patients treated using this approach is relatively smaller than the proportion of patients with EGC. However, surgeons experienced in minimally invasive gastrectomy techniques have suggested that they could be successfully applied to the treatment of advanced gastric cancer (AGC) 2,3,4,5,6,7,8…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

2014

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Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient's distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer.

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Section: Indication Of Mis For Gastric Cancermentioning

confidence: 99%

Section: Mis For Agcmentioning

confidence: 99%

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Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

2014

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“…However, the effects of laparoscopic surgery under CO2 pneumoperitoneum on the recurrence or progression of AGC are unknown. Park et al [25] found, by clinicopathological examination, that gastric cancer without lymph node metastasis (N0) and confined to the muscularis propria had an excellent prognosis and could be treated with LADG. Several recent reports from Japan and Italy describe good long-term outcomes after LADG for AGC (T2N0) [26,27].…”

Section: Advanced Gastric Cancer (Agc)mentioning

confidence: 99%

Laparoscopic gastrectomy with lymph node dissection for gastric cancer

2006

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surgery, including less invasiveness, less pain, earlier recovery, and better cosmesis [2]. Kitano et al. [3] first applied and described laparoscopy-assisted distal gastrectomy (LADG) as treatment for early gastric cancer (EGC) in 1994.With the development of various diagnostic modalities and the spread of mass screening, EGC now accounts for more than 50% of the total incidence of gastric cancer in Japan. The low frequency of lymph node metastasis in patients with EGC is well known; it reportedly occurs in 2%-5% of those with mucosal cancer and 11%-20% of those with submucosal cancer [4]. To allow for the treatment of EGC in patients without a risk of lymph node metastasis, laparoscopic wedge resection (LWR) with a lesion-lifting method was developed by Ohgami et al. [5] in 1992, and intragastric mucosal resection (IGMR) was developed by Ohashi [6] in the early 1990s. With the recent development of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) [7], the use of LWR and IGMR seems to be decreasing, whereas the use of LADG with lymph node dissection has increased in patients with EGC with a risk of lymph node metastasis.The past 15 years have seen remarkable advances in laparoscopic surgical techniques and instruments, such as laparoscopic coagulating shears [8]. Extended lymph node dissection (D2) and total gastrectomy can now be performed laparoscopically [9,10]. However, LADG remains controversial as a standard surgery for gastric cancer because there are few studies evaluating the technical difficulty, advantages, and oncological feasibility of LADG.Here, we review reports, in the English-language literature, of LADG with lymph node dissection as treatment for cancer, to clarify the current status of this technique and related problems. AbstractSince 1991, laparoscopic surgery has been adopted for the treatment of gastric cancer, and it has been performed worldwide, especially in Japan and Korea. We reviewed the English-language literature to clarify the current status of and problems associated with laparoscopic gastrectomy with lymph node dissection as treatment for gastric cancer. In Japan, early-stage gastric cancer (T1/T2, N0) is considered the only indication for laparoscopic gastrectomy. As yet, there is little high-level evidence based on long-term outcome supporting laparoscopic gastrectomy for cancer, but reports have provided level 3 evidence that the procedure is technically safe, and that it yields better short-term outcomes than open surgery; that is, recovery is faster, hospital stay is shorter, there is less pain, and cosmesis is better. However, investigation into the oncological outcome of laparoscopic gastrectomy as treatment for cancer is lacking. To establish laparoscopic surgery as a standard treatment for gastric cancer, multicenter randomized controlled trials to compare the short-and longterm outcomes of laparoscopic surgery versus open surgery are necessary.

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“…Initial indications for robotic gastrectomy were early gastric cancers without evidence of lymph node metastasis based on clinical diagnosis. It was expanded to include clinical stage T1‐2 cancers with or without perigastric lymph node metastasis, except for lesions for which endoscopic submucosal dissection (ESD) was indicated 8, 9. So far, in Korea and Japan, neither robotic nor laparoscopic gastrectomy is indicated for the treatment of serosa‐involved advanced gastric cancer 10.…”

Section: Indications Of Robotic Applicationmentioning

confidence: 99%

Robotic gastrectomy for gastric cancer: Current evidence

Alhossaini

Altamran

Seo

et al. 2017

Annals of Gastroent Surgery

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The robotic system has gained wide acceptance in specialties such as urological and gynecological surgery. It has also been applied in the field of upper gastrointestinal surgery. Since the first implementation of the robotic system for the treatment of gastric adenocarcinoma, the procedure has been found to be safe and feasible. Although robotic gastrectomy does not meet our expectations and yield better results than laparoscopic gastrectomy, this procedure seems to provide several advantages over laparoscopy such as reduced blood loss, shorter learning curves and increased number of retrieved lymph nodes. However, as many case series, including a recent multicenter study, have revealed, higher cost and longer operation time are the major limitations of robotic gastrectomy. Furthermore, there are no results from well‐designed randomized clinical trials comparing the two procedures. New procedures in much more technically demanding cases will test the genuine benefits of robotic gastrectomy.

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Gastric cancer confined to the muscularis propria: A possible candidate for laparoscopic surgery or adjuvant therapy

Cited by 14 publications

References 13 publications

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

Minimally Invasive Surgery for Gastric Cancer Treatment: Current Status and Future Perspectives

Laparoscopic gastrectomy with lymph node dissection for gastric cancer

Robotic gastrectomy for gastric cancer: Current evidence

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