Transectional gastrectomy: An old but renewed concept for early gastric cancer

Fujimura, Takashi; Fushida, Sachio; Kayahara, Masato; Ohta, Tetsuo; Kinami, Shinichi; Miwa, Koichi

doi:10.1007/s00595-009-4151-1

Cited by 12 publications

(14 citation statements)

References 35 publications

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“…We established function-preserving gastrectomy in combination with LBD on the basis of the favorable results of our feasibility study for the SN concept [18,36]. Functionpreserving gastrectomy for early gastric cancer includes not only transectional gastrectomy but also local resection, cardia resection, and antral resection.…”

Section: Function-preserving Gastrectomy As Snnsmentioning

confidence: 99%

A new stage of sentinel node navigation surgery in early gastric cancer

et al. 2014

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Sentinel node (SN) navigation surgery is expected to realize organ-and function-preserving surgery with SN mapping, and has been applied in operations for breast cancer and melanoma. But there has been no definite evidence for the SN concept in gastric cancer. A prospective multicenter trial to confirm the SN concept for gastric cancer conducted by the Japan Society of Sentinel Node Navigation Surgery reported that the SN detection rate, sensitivity of positive SNs, and accuracy of nodal status are 97.5 % (387/397), 93 % (53/57), and 99 % (383/ 387), respectively. A detailed analysis of the trial suggested that strictly the ''lymphatic basin concept'' rather than the ''SN concept'' was confirmed in early gastric cancer. The Japan Society of Sentinel Node Navigation Surgery started a new trial of function-preserving gastrectomy with lymphatic basin dissection (LBD) for early gastric cancer without metastasis in SNs on the basis of this promising outcome of the trial. It is supposed that LBD guarantees curability in SN navigation surgery for early gastric cancer. Full-thickness resection or endoscopic submucosal dissection in combination with laparoscopic LBD will soon be a new treatment option for early gastric cancer.

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Section: Function-preserving Gastrectomy As Snnsmentioning

confidence: 99%

A new stage of sentinel node navigation surgery in early gastric cancer

et al. 2014

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“…The indication for SG for gastric cancer is limited, similar to PPG. Fujimura et al [14] proposed a new SG technique using sentinel node navigation for early cancer located in the middle third of the stomach. The results of the questionnaire survey showed that only 23 institutions (16%) performed SG.…”

Section: Segmental Gastrectomymentioning

confidence: 99%

Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan

et al. 2012

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The Japanese Society for the Study of Postoperative Morbidity after Gastrectomy conducted a nationwide questionnaire survey to clarify the current status of reconstruction after gastrectomy. One hundred and forty-five institutions (66%) responded to the survey. The questionnaire dealt with the reconstruction after a distal gastrectomy, pylorus-preserving gastrectomy (PPG), total gastrectomy, and proximal gastrectomy. The most common method of reconstruction after distal gastrectomy was Billroth I in 112 institutions (74%), and Roux-en-Y (RY) in 30 (21%). Seventy-seven institutions (53%) responded to the PPG questions. The lengths of the antral cuff were widely distributed among the institutions. Segmental gastrectomy was performed by 23 institutions for limited cases. The most common method of reconstruction after total gastrectomy was RY in 138 institutions (95%). Reconstruction with a pouch after total gastrectomy was done in 26 institutions (18%). The most common reconstructions after proximal gastrectomy were esophagogastrostomy in 69 institutions (48%), jejunal interposition in 41 (28%), double tract in 19 (13%) and pouch reconstruction in 6 (7%). Although most Japanese surgeons are concerned about the revised methods of reconstruction and quality of life after gastrectomy, surgeons have not yet reached a full consensus on these issues.

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“…Pylorus-preserving gastrectomy (PPG), including transectional resection (TR) and local resection (LR), in patients with early gastric cancer along with lymphatic basin dissection, has been found to modulate gastric emptying and prevent DGR (23,24). Moreover, sleeve gastrectomy has been reported to lead to H. pylori eradication (25).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

et al. 2013

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Residual mucosa in the gastric stump after pylorus-preserving gastrectomy (PPG) is considered a risk factor for the development of gastric stump carcinoma (GSC). Duodenogastric reflux (DGR) and Helicobacter pylori (H. pylori) infection are suspected to contribute to the development of GSC. The aim of this study was to investigate the prevalence of H. pylori in the residual stomach after PPG for gastric cancer and to assess factors associated with the presence of H. pylori. We investigated 72 patients who had undergone PPG at least 1 year prior to the study and were confirmed to be positive for H. pylori infection on presurgical endoscopic biopsy. The extent of DGR, the prevalence of H. pylori infection based on H. pylori stool antigen (HpSA) tests and the severity of gastritis were analyzed in these post-PPG patients. None of the patients had DGR, as shown by (99m)Tc-PMT. Of the 72 post-PPG patients, 33 (46%) were positive for HpSA. The prevalence of H. pylori infection was significantly lower after surgery than before surgery. The endoscopic severity of remnant gastritis, as well as histological inflammation and activity, were higher in H. pylori-positive patients than in H. pylori-negative patients. In conclusion, some patients who undergo PPG and are negative for DGR experience spontaneous clearance of H. pylori infection.

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Transectional gastrectomy: An old but renewed concept for early gastric cancer

Cited by 12 publications

References 35 publications

A new stage of sentinel node navigation surgery in early gastric cancer

A new stage of sentinel node navigation surgery in early gastric cancer

Questionnaire survey regarding the current status and controversial issues concerning reconstruction after gastrectomy in Japan

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

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