Laparoscopic proximal gastrectomy for early gastric cancer

Surg Today. 2017 May;47(5):538-547. doi: 10.1007/s00595-016-1401-x. Epub 2016 Aug 22.

Abstract

The incidence of proximal early gastric cancer (EGC) is increasing, and while laparoscopic proximal gastrectomy (LPG) has been performed as a surgical option, it is not yet the standard treatment, because there is no established common reconstruction method following proximal gastrectomy (PG). We reviewed the English-language literature to clarify the current status and problems associated with LPG in treating proximal EGC. This procedure is considered indicated for EGC located in the upper third of the stomach with clinical T1N0, but not when it can be treated endoscopically. No operative mortality or conversion to open surgery was reported in our review, suggesting that this procedure is technically feasible. The most frequent postoperative complication involved problems with anastomoses, possibly caused by the technical complexity of the reconstruction. Although various reconstruction methods following open PG (OPG) and LPG have been reported, there is no standard reconstruction method. Well-designed multicenter, randomized, controlled, prospective trials to evaluate the various reconstruction methods are necessary.

Keywords: Cancer; Laparoscopic surgery; Proximal gastrectomy; Stomach.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Feasibility Studies
  • Gastrectomy / methods*
  • Humans
  • Japan
  • Laparoscopy / methods*
  • Neoplasm Staging
  • Plastic Surgery Procedures / methods*
  • Plastic Surgery Procedures / standards
  • Postoperative Complications
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*