Effectiveness of Endoscopic Clipping and Computed Tomography Gastroscopy for the Preoperative Localization of Gastric Cancer

Overview

Journal J Korean Surg Soc

Specialty General Surgery

Date 2013 Feb 12

PMID 23396626

Citations 14

Authors

Sang-Ho Jeong

Kyungsoo Bae

Chang-Youn Ha

Young-Joon Lee

Ok-Jae Lee

Woon-Tae Jung

Sang-Kyung Choi

Soon-Chan Hong

Eun-Jung Jung

Young-Tae Ju

Chi-Young Jeong

Woo-Song Ha

Affiliations

Soon will be listed here.

Abstract

Purpose: Before laparoscopic gastrectomy for gastric cancer can be planned, it is very important to know the precise location of the tumor. The aim of this study was to evaluate 3 methods of predicting the exact location of the tumor: preoperative gastrofibroscopy (GFS), preoperative computed tomography gastroscopy (CT), and intraoperative gastroscopy-guided laparoscopy (Lap).

Methods: In this study, 15 patients were prospectively identified, and endoscopic clips were preoperatively placed on the proximal 1 cm of the tumor, at the angle on the greater curvature and opposite the angle on the greater curvature. The distances between the pylorus and the proximal tumor clip (PT), the angle clip (PA), the greater curvature clip (PG), and the gastroesophageal junction were measured by preoperative GFS, preoperative CT, intraoperative Lap, and visual inspection (Vis).

Results: PT, PA, and PG values measured by preoperative GFS differed significantly from the Vis values (P < 0.01). However, preoperative CT measurements of PT, PA, and PG did not differ from the Vis values (P = 0.78, P = 0.48, and P = 0.53, respectively). Intraoperative Lap and Vis PT values differed by only 1.1 cm on an average (P = 0.10), but PA and PG values varied by 1.9 and 3.4 cm, respectively (P = 0.01 for both).

Conclusion: Endoscopic clipping combined with preoperative CT gastroscopy is more useful than preoperative GFS for preoperatively predicting the location of early gastric cancers and will be helpful for planning laparoscopic gastrectomy.

Citing Articles

Function Preserving Gastrectomy and Quality of Life.

Kim J, Lee H J Gastric Cancer. 2025; 25(1):247-260.

PMID: 39822178 PMC: 11739640. DOI: 10.5230/jgc.2025.25.e7.

Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline).

Kim I, Kang S, Choi W, Seo A, Eom B, Kang B J Gastric Cancer. 2025; 25(1):5-114.

PMID: 39822170 PMC: 11739648. DOI: 10.5230/jgc.2025.25.e11.

Chinese national clinical practice guidelines on the prevention, diagnosis, and treatment of early gastric cancer.

Li P, Li Z, Linghu E, Ji J Chin Med J (Engl). 2024; 137(8):887-908.

PMID: 38515297 PMC: 11046028. DOI: 10.1097/CM9.0000000000003101.

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach.

Kim T, Kim I, Kang S, Choi M, Kim B, Eom B J Gastric Cancer. 2023; 23(1):3-106.

PMID: 36750993 PMC: 9911619. DOI: 10.5230/jgc.2023.23.e11.

Clinicopathological features and management strategy for superficial nonampullary duodenal tumors: a multi-center retrospective study.

Kim E, Kim D, Lee H, Lee J, Kim J, Song K Ann Surg Treat Res. 2022; 102(5):263-270.

PMID: 35611085 PMC: 9111962. DOI: 10.4174/astr.2022.102.5.263.

References

Minami M, Kawauchi N, Itai Y, Niki T, Sasaki Y . Gastric tumors: radiologic-pathologic correlation and accuracy of T staging with dynamic CT. Radiology. 1992; 185(1):173-8. DOI: 10.1148/radiology.185.1.1523303. View

Adachi Y, SUEMATSU T, Shiraishi N, Katsuta T, Morimoto A, Kitano S . Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg. 1999; 229(1):49-54. PMC: 1191607. DOI: 10.1097/00000658-199901000-00006. View

Weyman R, Rao S . A novel clinical application for endoscopic mucosal clipping. Gastrointest Endosc. 1999; 49(4 Pt 1):522-4. DOI: 10.1016/s0016-5107(99)70056-8. View

Kim J, Song K, Chin H, Kim W, Jeon H, Park C . Totally laparoscopic gastrectomy with various types of intracorporeal anastomosis using laparoscopic linear staplers: preliminary experience. Surg Endosc. 2007; 22(2):436-42. DOI: 10.1007/s00464-007-9446-y. View

Song K, Park C, Kang H, Kim J, Park S, Jun K . Is totally laparoscopic gastrectomy less invasive than laparoscopy-assisted gastrectomy?: prospective, multicenter study. J Gastrointest Surg. 2008; 12(6):1015-21. DOI: 10.1007/s11605-008-0484-0. View

Lai Y, Yang S, Wu C, Chen T . Endoscopic hemoclip treatment for bleeding peptic ulcer. World J Gastroenterol. 2002; 6(1):53-56. PMC: 4723597. DOI: 10.3748/wjg.v6.i1.53. View

Kamangar F, Dores G, Anderson W . Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006; 24(14):2137-50. DOI: 10.1200/JCO.2005.05.2308. View

Kim J, Park S, Hong H, Auh Y . CT gastrography. Abdom Imaging. 2005; 30(5):509-17. DOI: 10.1007/s00261-004-0282-4. View

Ryu K, Lee J, Choi I, Bae J . Preoperative endoscopic clipping: localizing technique of early gastric cancer. J Surg Oncol. 2002; 82(1):75-7. DOI: 10.1002/jso.10191. View

10.

Kim Y, Baik Y, Yun Y, Nam B, Kim D, Choi I . Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008; 248(5):721-7. DOI: 10.1097/SLA.0b013e318185e62e. View

11.

Takaori K, Nomura E, Mabuchi H, Lee S, Agui T, Miyamoto Y . A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy. Am J Surg. 2005; 189(2):178-83. DOI: 10.1016/j.amjsurg.2004.09.008. View

12.

Kim A, Kim H, Ha H . Gastric cancer by multidetector row CT: preoperative staging. Abdom Imaging. 2005; 30(4):465-72. DOI: 10.1007/s00261-004-0273-5. View

13.

Kim S, Milsom J, Church J, LUDWIG K, Garcia-Ruiz A, Okuda J . Perioperative tumor localization for laparoscopic colorectal surgery. Surg Endosc. 1997; 11(10):1013-6. DOI: 10.1007/s004649900514. View

14.

Nizam R, Siddiqi N, Landas S, Kaplan D, Holtzapple P . Colonic tattooing with India ink: benefits, risks, and alternatives. Am J Gastroenterol. 1996; 91(9):1804-8. View

15.

Hyung W, Lim J, Cheong J, Kim J, Choi S, Song S . Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy. Surg Endosc. 2005; 19(10):1353-7. DOI: 10.1007/s00464-004-8196-3. View

16.

FUKUYA T, Honda H, Kaneko K, Kuroiwa T, Yoshimitsu K, Irie H . Efficacy of helical CT in T-staging of gastric cancer. J Comput Assist Tomogr. 1997; 21(1):73-81. DOI: 10.1097/00004728-199701000-00014. View

17.

Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T . Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009; 23(10):2374-9. DOI: 10.1007/s00464-009-0360-3. View

18.

Allam M, Mehta D, Zelen J, Fogler R . Posterior wall gastric leiomyoma: endoscopic tattooing facilitates laparoscopic resection. JSLS. 1999; 2(1):83-4. PMC: 3015267. View

19.

Kitano S, Iso Y, Moriyama M, Sugimachi K . Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994; 4(2):146-8. View

20.

Kim H, Han H, Choi J, Park C, Cha I, Chung K . Preoperative evaluation of gastric cancer: value of spiral CT during gastric arteriography (CTGA). Abdom Imaging. 2001; 26(2):123-30. DOI: 10.1007/s002610000167. View