Korean J Gastroenterol.  2017 Sep;70(3):134-140. 10.4166/kjg.2017.70.3.134.

Laparoscopic Proximal Gastrectomy as a Surgical Treatment for Upper Third Early Gastric Cancer

• Park DJ
• Park YS
• Ahn SH
• Kim HH

• KMID: 2390791
• DOI: http://doi.org/10.4166/kjg.2017.70.3.134

Abstract

Recently, the incidence of upper third gastric cancer has increased, and with it the number of endoscopic submucosal dissection (ESD) procedures performed has been increasing. However, if ESD is not indicated or non-curable, surgical treatment may be necessary. In the case of lower third gastric cancer, it is possible to preserve the upper part of the stomach; however, in the case of upper third gastric cancer, total gastrectomy is still the standard treatment option, regardless of the stage. This is due to the complications associated with upper third gastric cancer, such as gastroesophageal reflux after proximal gastrectomy rather than oncologic problems. Recently, the introduction of the double tract reconstruction method after proximal gastrectomy has become one of the surgical treatment methods for upper third early gastric cancer. However, since there has not been a prospective comparative study evaluating its efficacy, the ongoing multicenter prospective randomized controlled trial (KLASS-05) comparing laparoscopic proximal gastrectomy with double tract reconstruction and laparoscopic total gastrectomy is expected to be important for determining the future of treatment of upper third early gastric cancer.

Keyword

Stomach neoplasm; Laparoscopies; Gastrectomies; Surgical anastomosis

MeSH Terms

Anastomosis, Surgical
Gastrectomy*
Gastroesophageal Reflux
Incidence
Laparoscopy
Methods
Prospective Studies
Stomach
Stomach Neoplasms*

Figure

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  Fig. 1. Upper third early gastric cancer.

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  Fig. 2. Roux-en-Y esophagojejunostomy after laparoscopic total gas-trectomy.

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  Fig. 3. Direct esophagogastrostomy after laparoscopic proximal gas-trectomy.

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  Fig. 4. Double tract reconstruction after laparoscopic proximal gas-trectomy.

Reference

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