Laparoscopy-assisted Proximal Gastrectomy with Sentinel Node Mapping for Early Gastric Cancer

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2011 Sep 2

PMID 21882026

Citations 30

Authors

Hiroya Takeuchi

Takashi Oyama

Satoshi Kamiya

Rieko Nakamura

Tsunehiro Takahashi

Norihito Wada

Yoshiro Saikawa

Yuko Kitagawa

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopy-assisted proximal gastrectomy (LAPG) remains a relatively uncommon procedure because of certain technical issues, such as curability, safety, and retention of postoperative patients' quality of life. The aim of the present study was to evaluate the feasibility of a newly developed LAPG procedure for early-stage proximal gastric cancer.

Methods: We enrolled 37 consecutive patients who were preoperatively diagnosed with cT1N0M0 primary gastric cancer in the upper third of the stomach with the primary tumor diameter less than 4 cm. Laparoscopy-assisted proximal gastrectomy with sentinel node (SN) mapping and esophagogastric anastomosis with a circular stapler and transoral placement of the anvil was attempted.

Results: The LAPG procedure was completed in 36 patients. It was converted to laparoscopy-assisted total gastrectomy in one patient because one SN detected intraoperatively was positive for metastasis by intraoperative pathological diagnosis. There were no severe postoperative complications in any patient. Only one patient (3%) complained of mild reflux symptoms immediately after operation, which were graded endoscopically as B by the Los Angeles Classification of gastroesophageal reflux disease; however, the symptoms were controlled well by a proton-pump inhibitor. Sentinel nodes were detected successfully in 37 (100%) of our patients. The mean number of dissected lymph nodes and identified SNs per case was 29.7 and 5.8, respectively. The sensitivity of prediction of nodal metastasis (including isolated tumor cells) and diagnostic accuracy based on SN status were 100% (3/3) and 100% (37/37), respectively. All patients have been free from recurrence for a median follow-up period of 26 months.

Conclusions: This study reveals that our novel LAPG approach is curative and represents a feasible minimally invasive surgical procedure with minimal morbidity and postoperative reflux esophagitis in patients with upper-third early-stage gastric cancer.

Citing Articles

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Time interval after various types of gastrectomy until metachronous multiple gastric cancer: Analysis of data from a nationwide Japanese survey.

Kumagai K, Lee S, Ohira M, Aizawa M, Kamiya S, Takahata T Mol Clin Oncol. 2022; 16(2):54.

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Application of Magnetic Nanoparticles for Rapid Detection and In Situ Diagnosis in Clinical Oncology.

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The Results of Sentinel Node Mapping for Patients with Clinically Early Staged Gastric Cancer Diagnosed with pT2/deeper Tumors.

Takeuchi M, Kawakubo H, Shimada A, Hoshino S, Matsuda S, Mayanagi S World J Surg. 2021; 45(11):3350-3358.

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Non-flap hand-sewn esophagogastrostomy as a simple anti-reflux procedure in laparoscopic proximal gastrectomy for gastric cancer.

Komatsu S, Kosuga T, Kubota T, Kumano T, Okamoto K, Ichikawa D Langenbecks Arch Surg. 2020; 405(4):541-549.

PMID: 32504205 DOI: 10.1007/s00423-020-01900-4.

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