J Korean Med Assoc.  2015 Mar;58(3):197-200. 10.5124/jkma.2015.58.3.197.

Recent advances in minimally invasive surgery for gastric cancer

Affiliations
  • 1Gastric Cancer Branch, National Cancer Center, Goyang, Korea. docryu@korea.com

Abstract

Minimally invasive surgery (MIS) for gastric cancer was started from the early 1990s as laparoscopy-assisted distal gastrectomy (LADG). Currently, laparoscopic gastrectomy is the most popular surgical option in early gastric cancer (EGC) treatment. However, its application in advanced gastric cancer is still controversial and several clinical trials are ongoing. Another surgical tool for gastric cancer surgery is the robot. Robotic surgery is currently performed in a limited number of patients, primarily due to its high cost in Korea. Its safety is estimated to be equivalent to that of laparoscopic surgery, but its cost effectiveness is still controversial. To improve post-operative gastrointestinal function, modified gastrectomy procedures like pylorus-preserving gastrectomy (PPG) and proximal gastrectomy with double tract anastomosis have been tried but are still controversial. For minimizing gastric resection, wedge resection in EGC is proposed, applying the sentinel node (SN) concept, and this technique is now in clinical trials. Various approaches of MIS are now being trialed in gastric cancer patients in an attempt to identify strategies for improving surgical outcomes and patients' quality of life.

Keyword

Stomach neoplasms; Minimally invasive surgical procedures

MeSH Terms

Cost-Benefit Analysis
Gastrectomy
Humans
Korea
Laparoscopy
Quality of Life
Stomach Neoplasms*
Surgical Procedures, Minimally Invasive*

Cited by  2 articles

Update on gastric cancer treatment
Sang-Uk Han
J Korean Med Assoc. 2015;58(3):180-182.    doi: 10.5124/jkma.2015.58.3.180.

Management of long-term gastric cancer survivors in Korea
Dong Wook Shin, Seung Hyun Yoo, Sung Sunwoo, Moon-Won Yoo
J Korean Med Assoc. 2016;59(4):256-265.    doi: 10.5124/jkma.2016.59.4.256.


Reference

1. Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994; 4:146–148.
2. Kim HH, Han SU, Kim MC, Hyung WJ, Kim W, Lee HJ, Ryu SW, Cho GS, Song KY, Ryu SY. Long-term results of laparoscopic gastrectomy for gastric cancer: a large-scale case-control and case-matched Korean multicenter study. J Clin Oncol. 2014; 32:627–633.
Article
3. Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, Lee HJ, Song KY. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report: a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg. 2010; 251:417–420.
Article
4. Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M, Ito S, Takagi M, Takagane A, Ninomiya M, Fukushima N, Sasako M. A phase III study of laparoscopyassisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric Cancer (JCOG0912). Jpn J Clin Oncol. 2013; 43:324–327.
Article
5. Hyun MH, Lee CH, Kim HJ, Tong Y, Park SS. Systematic review and meta-analysis of robotic surgery compared with conventional laparoscopic and open resections for gastric carcinoma. Br J Surg. 2013; 100:1566–1578.
Article
6. Kitagawa Y, Takeuchi H, Takagi Y, Natsugoe S, Terashima M, Murakami N, Fujimura T, Tsujimoto H, Hayashi H, Yoshimizu N, Takagane A, Mohri Y, Nabeshima K, Uenosono Y, Kinami S, Sakamoto J, Morita S, Aikou T, Miwa K, Kitajima M. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol. 2013; 31:3704–3710.
Article
7. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, Ponzano C. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg. 2005; 241:232–237.
Article
8. Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, Bae JM. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008; 248:721–727.
Article
9. Kim YW, Yoon HM, Yun YH, Nam BH, Eom BW, Baik YH, Lee SE, Lee Y, Kim YA, Park JY, Ryu KW. Long-term outcomes of laparoscopy-assisted distal gastrectomy for early gastric cancer: result of a randomized controlled trial (COACT 0301). Surg Endosc. 2013; 27:4267–4276.
Article
10. Kim HI, Hur H, Kim YN, Lee HJ, Kim MC, Han SU, Hyung WJ. Standardization of D2 lymphadenectomy and surgical quality control (KLASS-02-QC): a prospective, observational, multicenter study [NCT01283893]. BMC Cancer. 2014; 14:209.
Article
11. Li G. Multicenter study on laparoscopic distal subtotal gastrectomy for advanced gastric cancer (CLASS-01) [Internet]. Bethesda: ClinicalTrials.gov;2015. cited 2014 Feb 9. Available from: https://clinicaltrials.gov/show/NCT01609309.
12. Hyung HJ. Multi-institutional study on the assessment of robotic surgery for gastric cancer [Internet]. Bethesda: ClinicalTrials.gov;2013. cited 2014 Feb 9. Available from: https://www.clinicaltrials.gov/ct2/show/NCT01309256.
13. Suh YS, Han DS, Kong SH, Kwon S, Shin CI, Kim WH, Kim HH, Lee HJ, Yang HK. Laparoscopy-assisted pylorus-preserving gastrectomy is better than laparoscopy-assisted distal gastrectomy for middle-third early gastric cancer. Ann Surg. 2014; 259:485–493.
Article
14. Ahn SH, Jung do H, Son SY, Lee CM, Park do J, Kim HH. Laparoscopic double-tract proximal gastrectomy for proximal early gastric cancer. Gastric Cancer. 2014; 17:562–570.
Article
15. Park JY, Ryu KW, Eom BW, Yoon HM, Kim SJ, Cho SJ, Lee JY, Kim CG, Kook MC, Choi IJ, Nam BH, Kim YW. Proposal of the surgical options for primary tumor control during sentinel node navigation surgery based on the discrepancy between preoperative and postoperative early gastric cancer diagnoses. Ann Surg Oncol. 2014; 21:1123–1129.
Article
16. Ryu KW. Multicenter phase III trial of laparoscopic sentinel node biopsy [Internet]. Bethesda: ClinicalTrials.gov;2013. cited 2014 Feb 9. Available from: https://www.clinicaltrials.gov/ct2/show/NCT01804998.
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