Surgical technique of suprapancreatic D2 lymphadenectomy focusing on the posterior hepatic plexus for advanced gastric cancer

2022 ◽  
Author(s):  
Nobuhiko Kanaya ◽  
Shinji Kuroda ◽  
Yoshihiko Kakiuchi ◽  
Sho Takeda ◽  
Satoru Kikuchi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Technique ◽  
Advanced Gastric Cancer ◽  
D2 Lymphadenectomy

scholarly journals Totally Laparoscopic Total Gastrectomy with D2 Lymphadenectomy for Advanced Gastric Cancer

2015 ◽  
Vol 06 (06) ◽  
pp. 247-254
Author(s):  
Hironobu Takano ◽  
Yuma Ebihara ◽  
Yo Kurashima ◽  
Soichi Murakami ◽  
Toshiaki Shichinohe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Totally Laparoscopic Total Gastrectomy ◽  
Totally Laparoscopic

Is it necessary to dissect the posterior lymph nodes along the splenic vessels during total gastrectomy with D2 lymphadenectomy for advanced gastric cancer?

2017 ◽  
Vol 43 (12) ◽  
pp. 2357-2365 ◽  
Author(s):  
Jian-Xian Lin ◽  
Chang-Ming Huang ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Splenic Vessels

Long-Term Outcomes of Laparoscopic Distal Gastrectomy for Locally Advanced Gastric Cancer: The KLASS-02-RCT Randomized Clinical Trial

2020 ◽  
Vol 38 (28) ◽  
pp. 3304-3313 ◽  
Author(s):  
Woo Jin Hyung ◽  
Han-Kwang Yang ◽  
Young-Kyu Park ◽  
Hyuk-Joon Lee ◽  
Ji Yeong An ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Open Surgery ◽  
Distal Gastrectomy ◽  
Locally Advanced ◽  
Laparoscopic Distal Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Locally Advanced Gastric Cancer

PURPOSE It is unclear whether laparoscopic distal gastrectomy for locally advanced gastric cancer is oncologically equivalent to open distal gastrectomy. The noninferiority of laparoscopic subtotal gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer compared with open surgery in terms of 3-year relapse-free survival rate was evaluated. PATIENTS AND METHODS A phase III, open-label, randomized controlled trial was conducted for patients with histologically proven locally advanced gastric adenocarcinoma suitable for distal subtotal gastrectomy. The primary end point was the 3-year relapse-free survival rate; the upper limit of the hazard ratio (HR) for noninferiority was 1.43 between the laparoscopic and open distal gastrectomy groups. RESULTS From November 2011 to April 2015, 1,050 patients were randomly assigned to laparoscopy (n = 524) or open surgery (n = 526). After exclusions, 492 patients underwent laparoscopic surgery and 482 underwent open surgery and were included in the analysis. The laparoscopy group, compared with the open surgery group, suffered fewer early complications (15.7% v 23.4%, respectively; P = .0027) and late complications (4.7% v 9.5%, respectively; P = .0038), particularly intestinal obstruction (2.0% v 4.4%, respectively; P = .0447). The 3-year relapse-free survival rate was 80.3% (95% CI, 76.0% to 85.0%) for the laparoscopy group and 81.3% (95% CI, 77.0% to 85.0%; log-rank P = .726) for the open group. Cox regression analysis after stratification by the surgeon revealed an HR of 1.035 (95% CI, 0.762 to 1.406; log-rank P = .827; P for noninferiority = .039). When stratified by pathologic stage, the HR was 1.020 (95% CI, 0.751 to 1.385; log-rank P = .900; P for noninferiority = .030). CONCLUSION Laparoscopic distal gastrectomy with D2 lymphadenectomy was comparable to open surgery in terms of relapse-free survival for patients with locally advanced gastric cancer. Laparoscopic distal gastrectomy with D2 lymphadenectomy could be a potential standard treatment option for locally advanced gastric cancer.

scholarly journals Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer

1999 ◽  
Vol 2 (4) ◽  
pp. 230-234 ◽  
Author(s):  
Ichiro Uyama ◽  
Atsushi Sugioka ◽  
Junko Fujita ◽  
Akitake Hasumi ◽  
Yoshiyuki Komori ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Distal Pancreatosplenectomy

scholarly journals Prognostic Significance of Preoperative Serum Uric Acid to Lymphocyte Ratio in Advanced Gastric Cancer A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Li Heng Liu ◽  
Shan Shan Hu ◽  
Cheng Lei Liao ◽  
ziwei wang
Keyword(s):  
Gastric Cancer ◽  
Uric Acid ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Prognostic Significance ◽  
D2 Lymphadenectomy ◽  
Entire Cohort ◽  
Lymphocyte Ratio ◽  
Incidence And Mortality ◽  
High Level

Abstract Purpose: Gastric cancer ranks sixth and second in incidence and mortality among all cancer. The purpose of our research was to evaluate the prognostic value of uric acid to lymphocyte ratio (ULR) for advanced gastric cancer (AGC) patients after gastrectomy with D2 lymphadenectomy.Methods: In this research, we included 287 AGC patients underwent gastrectomy with D2 lymphadenectomy. These patients were followed up for 5 years, and their clinicopathological data were collected. All patients were divided into two groups based on the preoperative ULR level. Then we established the propensity score matching (PSM) cohort to confirm our results. Finally, The clinical characteristics and survival indexes of the two groups in the PSM cohort and the entire cohort were compared. Results：We found that age and gender were significantly correlated with the ULR level. Multivariate analysis for the entire cohort and PSM cohort showed that high levels of ULR, poor differentiation, postoperative pathology of T4 stage, and regional lymph node metastasis were independent prediction factors for poor outcomes of overall survival (OS) and Disease-free survival (DFS) in patients with AGC after gastrectomy with D2 lymphadenectomy. Survival analysis showed that the OS and DFS in the high level ULR group were significantly shorter than in the low level ULR group (log-rank P < 0.001). Conclusion: High level ULR is a poor predictive factor for patients with AGC underwent gastrectomy with D2 lymphadenectomy, and high levels of ULR predict shorter OS and DFS.

Short-term outcomes of laparoscopic D2 gastrectomy with complete mesogastrium excision (D2+CME) for advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 43-43
Author(s):  
Daxing Xie ◽  
Jianping Gong
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Cells ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Soft Tissues ◽  
R0 Resection ◽  
D2 Lymphadenectomy ◽  
Short Term ◽  
The Mean

43 Background: D2 lymphadenectomy has been widely accepted as a standard procedure of surgical treatment for local advanced gastric cancer [1,2]. However, neither the dissection boundary nor the extent of the excision for perigastric soft tissues has been described [3-7]. Our previous researches demonstrate the existence of disseminated cancer cells in the mesogastrium [8, 9] and present an understandable mesogastrium model for gastrectomy [10]. Hence, the D2 lymphadenectomy plus complete mesogastrium excision (D2+CME) is firstly proposed in this study, aiming to assess the safety, feasibility and corresponding short-term surgical outcomes. Methods: All of these patients underwent laparoscopy assisted D2+CME radical gastrectomy with a curative R0 resection, and all the operation was performed by Prof. Jianping Gong, chief of GI surgery of Tongji Hospital, Huazhong University of Science and Technology. All participants provided informed written consent to participate in the study. This study was approved by the Tongji Hospital Ethics Committee. The standard surgical procedures in the video are described as follows. Reconstruction of the alimentary tract was done by extracorporeal anastomosis. Standard recovery protocols were followed in postoperative treatments. Results: 68 patients between September 2014 and March 2016 have been recruited with informed consent and underwent laparoscopic D2+CME by a single surgeon. The mean number of retrieved regional lymph nodes was 33.62±11.40 (ranges 14-55). The mean volume of blood loss was 12.44±22.89 ml (ranges 5-100). The mean laparoscopic surgery time was 127.82±17.63 mins (ranges 110-165). The mean hospitalization time was 16.5±3.3 days (ranges 8-28). No operative complication was observed during the hospitalization. Conclusions: The anatomical boundary of mesogastrium is well described and dissected within D2+CME surgical process. It proves to be safely feasible and repeatable with less blood lost, qualified lymph nodes, retrieval results, and other improved short-term surgical outcomes in advanced gastric cancer. Meanwhile, potential disseminated cancer cells fall into the mesogastrium can be eradicated by D2+CME. Clinical trial information: NCT01978444.

scholarly journals D2 lymphadenectomy can disseminate tumor cells into peritoneal cavity in patients with advanced gastric cancer

Neoplasma ◽  
2012 ◽  
Vol 60 (02) ◽  
pp. 174-181 ◽  
Author(s):  
X. F. YU ◽  
Z. G. REN ◽  
Y. W. XUE ◽  
H. T. SONG ◽  
Y. Z. WEI ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Tumor Cells ◽  
Peritoneal Cavity ◽  
D2 Lymphadenectomy

Short-term outcomes of laparoscopic D2 lymphadenectomy with complete mesogastrium excision for advanced gastric cancer

2016 ◽  
Vol 30 (11) ◽  
pp. 5138-5139 ◽  
Author(s):  
Daxing Xie ◽  
Chaoran Yu ◽  
Liang Liu ◽  
Hasan Osaiweran ◽  
Chun Gao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
D2 Lymphadenectomy ◽  
Short Term
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