Laparoscopic approach for early gastric cancer within a paraesophageal hiatal hernia

Abstract

We present a case of early gastric cancer located in gastric volvulus associated with paraesophageal hiatal hernia. Two lesions of EGC were diagnosed in the distal third of the stomach, most of which had herniated into the left chest through a large hiatal defect in an organoaxial fashion. Routinely, laparoscopic-assisted distal gastrectomy (LADG) is our preferred approach for EGC, and the presence of hiatal hernia in this case did not alter our approach. Laparoscopic repair of hiatal hernia was performed successfully followed by LADG. A review of the literature supports a minimally invasive approach for both procedures and shows it to be safe, effective, and technically feasible. Further, LADG is shown to be oncologically adequate in terms of tumor margins and lymph node dissection, but its relevance to long-term disease-free survival still needs to be studied in well-designed prospective trials.

Totally laparoscopic gastrectomy for early gastric cancer accompanied by huge hiatal hernia: A case report

“…Shah et al . first reported the laparoscopic approach for early gastric cancer within a paraesophageal hiatal hernia in 2004, but only with an English abstract . As of 31 January 2015, five cases, including our case, of laparoscopic gastrectomy for gastric cancer accompanied by hiatal hernia have been reported in Japan (Table ) .…”