Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer

Tanimura, Shinya; Higashino, Masayuki; Fukunaga, Yosuke; Kishida, Satoru; Ogata, Akihito; Fujiwara, Yushi; Osugi, Harushi

doi:10.1002/bjs.5542

Cited by 78 publications

(19 citation statements)

References 4 publications

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“…The results of laparoscopic proximal gastrectomy for upper third EGC have also been reported 52,53. The long-term results for patients who received a total gastrectomy were significantly worse compared with patients who received a partial gastrectomy 60.…”

Section: Mis For Function Preservationmentioning

confidence: 94%

“…Initially, pylorus-preserving gastrectomy (PPG) was a surgical option for gastric ulcers 49. This method, and other limited methods, provide a better quality of life and oncologic safety when used for selected types of gastric cancer 50,51,52,53. Advantages of pylorus-preserving gastrectomy with gastrogastrostomy include less dumping syndrome, less bile reflux, less weight loss, and decreased gallstone formation 50,54,55,56,57.…”

Section: Mis For Function Preservationmentioning

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: Mis For Function Preservationmentioning

confidence: 94%

Section: Mis For Function Preservationmentioning

confidence: 99%

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

2014

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“…In this situation, a longer laparotomy is required, which might weaken the merits of the laparoscopic approach. For this reason, several modified reconstructive methods by means of a mini-laparotomy have been introduced [5-7]. A side-to-side E-J anastomosis has been introduced through a mini-laparotomy using an endoscopic linear stapler instead of a circular stapler [7].…”

Section: Discussionmentioning

confidence: 99%

Safety of intracorporeal circular stapling esophagojejunostomy using trans-orally inserted anvil (OrVil™) following laparoscopic total or proximal gastrectomy - comparison with extracorporeal anastomosis

et al. 2013

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BackgroundThere have been several attempts to develop a unique and easier way to perform esophagojejunostomy during laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy. The OrVil™ system (Covidien, Mansfield, MA, USA) is one of those methods, but its technical and oncologic feasibility have not been proven and need to be observed.MethodsAmong 87 patients who underwent laparoscopy-assisted total gastrectomy (LATG; 79 cases) and laparoscopy-assisted proximal gastrectomy with double tract anastomosis (LAPG_DT; 8 cases) from April 2004, 47 patients underwent the conventional extracorporeal method (Group I; 2004–2008) were compared with 40 patients treated with the intracorporeal OrVil™ system (Group II; 2009–2012).ResultsThere was no significant difference in clinicopathologic characteristics between the two groups except tumor location; more cardia lesions were involved in group II (p = 0.012). The mean time for esophagojejunostomy (E-J), defined as the time from anvil insertion to closure of the jejunal entry site has no significant difference (Group I vs II: 22.2 ± 3.2 min vs 18.6 ± 3.5 min, p = 0.623). In terms of anastomotic complication, there was no significant difference in E-J leakage and stricture. E-J leakage occurred in 2 out of 47 (4.3%) cases in group I and 2 out of 40 (5%) in group II (p = 0.628); half of them were treated conservatively in each group and the others underwent reoperation. E-J stricture occurred in 2 (4.3%) cases in group I and 1 (2.5%) in group II (p = 0.561), which required postoperative gastrofiberscopic balloon dilatation.ConclusionsEsophagojejunostomy using the OrVil™ system was a feasible and safe technique compared with the conventional extracorporeal method through mini-laparotomy in terms of anastomotic complications. Moreover, it can help to reduce surgeon’s stress regarding esophagojejunostomy because it needs no purse-string procedure and serves a secure operation view laparoscopically.

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“…The criteria for PG in our institute were: 1) a primary tumor located in the upper one-third of the stomach; 2) cancerous invasion not extending beyond the submucosal layer (T1); and 3) no macroscopic evidence of lymph node metastasis (N0) at the time of surgery [7,8]. Recently, laparoscopic gastrectomy and reconstruction have been adopted as a potentially less invasive surgical approach [9,10]. We have recently been performing laparoscopic PG for early gastric cancer, with reconstruction by the double tract (DT) method.…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes by reconstruction technique following laparoscopic proximal gastrectomy for gastric cancer: double tract versus jejunal interposition

et al. 2014

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BackgroundFor early gastric cancer located in the upper third of the stomach, we have adopted laparoscopic 1/2-proximal gastrectomy (PG) with two types of reconstruction: double tract reconstruction (L-DT) and jejunal interposition reconstruction with crimping of the jejunum on the anal side of the jejunogastrostomy with a knifeless linear stapler (L-JIP).MethodsFunctional outcomes were prospectively compared between these two types of reconstruction following laparoscopic PG. Resection and reconstruction were performed using L-DT (n = 10) and L-JIP (n = 10) alternately. Quality of life was evaluated through a questionnaire and endoscopic examination of the ten patients in each group, and functional evaluations were carried out in five patients of each group.ResultsThe postoperative/preoperative body weight ratio was significantly higher in the L-JIP group than in the L-DT group. While the incidence of reflux esophagitis was 10% in both groups, the endoscope could reach the remnant stomach in all patients. In the L-DT group, the plasma acetaminophen concentration at 15 minutes and the insulin level at 30 minutes were markedly increased after oral administration, while the increases in the blood sugar level at 30 and 60 minutes were more gradual than in the L-JIP group.ConclusionsWhile L-JIP may be thought of as the ideal method for function-preserving gastrectomy, L-DT may be suitable for gastric cancer patients with impaired glucose tolerance. These results raise the possibility of individualized selection of reconstruction for gastric cancer patients with various kinds of preoperative complications.

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Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer

Abstract: Laparoscopic gastrectomy for upper gastric cancer appears to be a safe and curative procedure.

Cited by 78 publications

References 4 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

Safety of intracorporeal circular stapling esophagojejunostomy using trans-orally inserted anvil (OrVil™) following laparoscopic total or proximal gastrectomy - comparison with extracorporeal anastomosis

Functional outcomes by reconstruction technique following laparoscopic proximal gastrectomy for gastric cancer: double tract versus jejunal interposition

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