J Minim Invasive Surg.  2019 Mar;22(1):3-4. 10.7602/jmis.2019.22.1.3.

Is Laparoscopic Approach Also Safe for the Treatment of Remnant Gastric Cancer?

• Song KY

• KMID: 2441995
• DOI: http://doi.org/10.7602/jmis.2019.22.1.3

Abstract

The most important advantages of laparoscopic gastrectomy are the minimal invasiveness, including less postoperative pain, shorter recovery, and minimal complications. A laparoscopic distal gastrectomy is accepted widely as a standard treatment for gastric cancer. On the other hand, a laparoscopic total gastrectomy has not been popularized as a distal gastrectomy because of the complexity of a lymph node dissection and the diversity of reconstruction. In terms of laparoscopic surgery for a remnant gastrectomy, there are three key points, which are critical for safe operation: adequate lymph node dissection, meticulous adhesiolysis, and reconstruction. After radical surgery for gastric cancer, the intra-abdominal condition is greatly changed. In addition, the lymphatic anatomy around the stomach is broken and surgeons should be aware of a newly developed lymphatic system to perform adequate node dissection. An esophago-jejunal reconstruction is at risk of leakage. Until evidence that is more concrete can be obtained, experienced surgeons should consider the laparoscopic approach.

Keyword

Gastrectomy; Gastric cancer; Gastric remnant; Laparoscopy; Lymph node dissection

MeSH Terms

Gastrectomy
Gastric Stump
Hand
Laparoscopy
Lymph Node Excision
Lymphatic System
Pain, Postoperative
Stomach
Stomach Neoplasms*
Surgeons