Complete Mesogastric Excisions Involving Anatomically Based Concepts and Embryological-Based Surgeries: Current Knowledge and Future Challenges

Curr Oncol. 2021 Nov 22;28(6):4929-4937. doi: 10.3390/curroncol28060413.

Abstract

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept.

Keywords: anatomical dissection; embryological planes; gastric cancer; mesogastrium.

Publication types

  • Review

MeSH terms

  • Gastrectomy / methods
  • Humans
  • Lymph Node Excision / methods
  • Mesentery / pathology
  • Mesentery / surgery
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / surgery
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery