Is Laparoscopic Approach Also Safe for the Treatment of Remnant Gastric Cancer?
- Author:
Kyo Young SONG
1
Author Information
- Publication Type:Editorial
- Keywords: Gastrectomy; Gastric cancer; Gastric remnant; Laparoscopy; Lymph node dissection
- MeSH: Gastrectomy; Gastric Stump; Hand; Laparoscopy; Lymph Node Excision; Lymphatic System; Pain, Postoperative; Stomach; Stomach Neoplasms; Surgeons
- From:Journal of Minimally Invasive Surgery 2019;22(1):3-4
- CountryRepublic of Korea
- Language:English
- 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.
