Laparoscopic Wedge Resection of the Stomach for Early Gastric Cancer Using a Lesion-Lifting Method

Ohgami, Masahiro; Kumai, Koichiro; Otani, Yoshihide; Wakabayashi, Go; Kubota, Tetsuro; Kitajima, Masaki

doi:10.1159/000172226

Cited by 90 publications

(73 citation statements)

References 2 publications

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“…A variety of minimally invasive treatments for early gastric cancer have been reported, such as EMR [1][2][3][4], laparoscopic wedge resection [5], and laparoscopic intraluminal surgery [6]. However, these operations do not include regional LN dissection.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it would seem logical to carry out the resection of perigastric LNs, at least for patients with early gastric cancer. In this respect, LADG has higher curability (similar to that of conventional ODG with regional LN dissection) than that of the above-mentioned operations [1][2][3][4][5][6]. However, the usefulness of and indications for LADG still remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…New techniques, such as endoscopic mucosal resection (EMR) [1][2][3][4], laparoscopic partial resection [5], and intragastric surgery [6], have been reported as minimally invasive surgery for early gastric cancer. However, in these operations, the regional lymph nodes (LNs) around the primary tumor cannot be resected.…”

Section: Introductionmentioning

confidence: 99%

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The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer

et al. 2001

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Generally, LN metastases are seen in a small percentage of patients with early gastric cancer with mucosal or submucosal invasion [7]. In recent years, the technique of laparoscopy-assisted distal gastrectomy (LADG) with regional LN dissection has been developed and employed for early gastric cancer [8]. In March, 1997, we began to perform LADG as a minimally invasive surgery for early gastric cancer. However, the feasibility of LADG for early gastric cancer and the associated clinical outcome of patients who undergo LADG for early gastric cancer remain unclear.We therefore conducted a review of patients who underwent LADG for early gastric cancer, in an effort to compare the operative times, intra-operative blood loss, number of removed lymph nodes, postoperative recovery, and morbidity and mortality rates of LADG and conventional open distal gastrectomy (ODG). Our research was aimed at determining whether the laparoscopic procedure of LADG for early gastric cancer is really safe and minimally invasive, and whether or not the LADG improves quality of life, compared with ODG. Patients and methods PatientsThe patients were preoperatively diagnosed as having an early gastric cancer located in the lower or middle third of the stomach, from the results of endoscopy, endoscopic ultrasonography (EUS), and examination of biopsy specimens. The indications for LADG were that: (1) the tumor was located in the middle or lower part of the stomach, (2) the invasion of the tumor was limited to the mucosal layer or the submucosal layers (SM1). Results. The clinical and pathological backgrounds of the patients in the two groups were similar. The duration of surgery was not significantly different between the two groups, but the blood loss in the LADG group was significantly less than that in the ODG group. The number of removed lymph nodes was not significantly different between the two groups. The times to the first passing of flatus, first walking, and the restarting of oral intake; the length of hospital stay; and the duration of epidural analgesia were significantly shorter in the LADG group. The morbidity rate in the LADG group was lower than that in the ODG group. Conclusions. LADG is a safe and minimally invasive surgical technique, after which we can expect a faster recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer

et al. 2001

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“…Laparoscopic surgery is another approach for the treatment of early gastric cancer [91][92][93][94][95][96]. Ohgami et al [91] first developed laparoscopic wedge resection of the stomach, using a lesion-lifting method.…”

Section: New Therapeutic Trendsmentioning

confidence: 99%

Surgery for gastric cancer: 10-year experience worldwide

2001

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extended lymph node dissection has been traditional in Japan, and critical studies from several Western countries suggest that there are improved surgical results after extended lymph node dissection. Therefore, it is important to evaluate the current information on the clinical and pathological characteristics of, and the surgical results for gastric cancer worldwide.To demonstrate recent experience of gastric cancer surgery throughout the world and to evaluate modern strategies for the treatment of gastric cancer, we investigated the English-language literature of the past 10 years, reviewed more than 100 studies concerning controversial issues in gastric cancer treatment, and assessed the current status of gastric cancer surgery worldwide. This review was generally based on promising papers published in well known medical journals, and focused on the following items: (1) surgical results worldwide, (2) lymph node metastasis, (3) lymph node dissection, (4) splenectomy, (5) prognostic factors, and (6) new therapeutic trends. Surgical results worldwideThe review of English-language publications from 1970 to 1990 showed that the operative mortality rate following surgery for gastric cancer had declined to a mean of 8% and a median of 5% [1]. In the British hospital, operative mortality decreased from 15% to 7%, and the 5-year survival rate increased from 5% to 11% [2]. In another British hospital, the proportion of patients with early gastric cancer rose from 1% to 15%, that of stage I disease rose from 4% to 26%, and that of potentially curative resection rose from 31% to 53% [3]. After curative resection, the 5-year survival rate was 60%, and the operative mortality and morbidity rates were 6% and 17%, respectively.In Sweden, the 5-year surival rate after gastrectomy for cancer increased from 19% to 25%, mainly owing to Abstract To demonstrate recent experience of gastric cancer surgery worldwide and to evaluate modern strategies for the treatment of gastric cancer, we investigated the English-language literature of the past 10 years, based on papers published in well-known medical journals. In many countries, the increased detection of early gastric cancer, advanced operative procedures, and careful postoperative management have improved the surgical results of gastric cancer over the years. Although randomized controlled trials in Europe showed no survival benefit of D2 resection over D1 resection, the results must be interpreted with caution and cannot be extrapolated to Japanese patients, because the morbidity and mortality after D2 gastrectomy in Japan are much less than those after D1 gastrectomy in Europe. Recently, less invasive treatments, including endoscopic mucosal resection and laparoscopic gastrectomy, have become feasible for patients with early gastric cancer, but their risks and benefits compared with traditional gastrectomy are unclear.

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“…The recent advent of endoscopic and laparoscopic local treatments has offered a better quality of life to patients with early gastric carcinoma involving no lymph node metastasis [1][2][3][4][5]. These treatments, however, incur increasing risks of missing the coexistence of accessory (microscopic) carcinomas and/or developing new cancers in the remnant stomach [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

BGP expression in gastric biopsies may predict the development of new lesions after local treatment for early gastric cancer

et al. 2002

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Laparoscopic Wedge Resection of the Stomach for Early Gastric Cancer Using a Lesion-Lifting Method

Cited by 90 publications

References 2 publications

The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer

The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer

Surgery for gastric cancer: 10-year experience worldwide

BGP expression in gastric biopsies may predict the development of new lesions after local treatment for early gastric cancer

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