scholarly journals Patterns of regional nodal relapse after D2 lymphadenectomy in gastric cancer: rethinking the target volume

2018 ◽  
Vol Volume 11 ◽  
pp. 8015-8024
Author(s):  
Wang Yang ◽  
Menglong Zhou ◽  
Ran Hu ◽  
Guichao Li ◽  
Yan Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Target Volume ◽  
D2 Lymphadenectomy ◽  
Nodal Relapse

scholarly journals PO-0768: Patterns of nodal relapse after D2 dissection in gastric cancer: rethinking the target volume

2018 ◽  
Vol 127 ◽  
pp. S396-S397
Author(s):  
Y. Wang ◽  
H. Ran ◽  
Z. Menglong ◽  
L. Guichao ◽  
W. Yan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Target Volume ◽  
D2 Dissection ◽  
Nodal Relapse

scholarly journals Adjuvant chemoradiotherapy after d2-lymphadenectomy for gastric cancer: the role of n-ratio in patient selection. results of a single cancer center

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Wilson L Costa ◽  
Felipe JF Coimbra ◽  
Ricardo C Fogaroli ◽  
Héber SC Ribeiro ◽  
Alessandro L Diniz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Patient Selection ◽  
Adjuvant Chemoradiotherapy ◽  
Cancer Center ◽  
D2 Lymphadenectomy ◽  
Single Cancer

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

scholarly journals Robotic distal subtotal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a case report and technical description

2020 ◽  
Vol 2 (1) ◽  
pp. 18-21
Author(s):  
Francesco Giovanardi
Keyword(s):  
Gastric Cancer ◽  
Case Report ◽  
Three Dimensional ◽  
Subtotal Gastrectomy ◽  
Gastric Surgery ◽  
Robotic Systems ◽  
D2 Lymphadenectomy ◽  
Tips And Tricks ◽  
Technical Details ◽  
Three Dimensional Vision

Robotic systems have revolutionized the way we perform minimally invasive surgery and has facilitated the evolution of traditional laparoscopic gastric surgery. Surgeons have several advantages that can overcome some of the well-known limits of laparoscopy: three-dimensional vision, articulated instruments, the absence of tremors. These can give greater dexterity and precision in dissection and suturing movements that are key elements when performing complex and gentle reconstruction to restore digestive continuity. The present case shows the technical details and tips and tricks of a robotic surgical approach for a subtotal gastrectomy.

scholarly journals Routine modifed D2 lymphadenectomy performance inpT1-T2N0 gastric cancer

2009 ◽  
Vol 15 (44) ◽  
pp. 5568 ◽  
Author(s):  
John Griniatsos ◽  
Hara Gakiopoulou ◽  
Eugenia Yiannakopoulou ◽  
Nikoletta Dimitriou ◽  
Gerasimos Douridas ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
D2 Lymphadenectomy

scholarly journals Impact of the introduction of formal D2 lymphadenectomy for gastric cancer in a Western setting

2021 ◽  
Vol 64 (2) ◽  
Author(s):  
Alexandre Brind’Amour ◽  
Jean-Pierre Gagné ◽  
Jean-Charles Hogue ◽  
Éric Poirier
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Gastric Resection ◽  
Training Group ◽  
Technical Training ◽  
Perioperative Outcomes ◽  
D2 Lymphadenectomy ◽  
Term Survival ◽  
Long Term Survival

Background: Two members from an academic tertiary hospital went to the National Cancer Institute in Tokyo, Japan, to learn how to perform an adequate D2 lymphadenectomy and to then introduce this technique in the surgical care of patients undergoing surgery for gastric cancer at a Western hospital. We aimed to compare the perioperative outcomes and long-term survival of Western patients who underwent gastric resection, performed by these 2 surgeons, before and after the surgeons’ shortcourse technical training in Japan. Methods: We conducted a retrospective comparative study of all patients (n = 27 before training and n = 79 after training) who underwent gastric resection for cancer by the same 2 surgeons between September 2007 and December 2017 at the Centre Hospitalier Universitaire de Québec — Université Laval (Québec, Canada). We collected data on patient demographic, clinical, surgical, pathological and treatment characteristics, as well as long-term survival and complications. Results: In the post-training group, the number of sampled lymph nodes was higher (median 33 v. 14, p < 0.0001), but this increase did not result in a higher number of histologically positive lymph nodes (p = 0.35). The rate of complications was lower in the post-training group (15.2% v. 48.2%, p = 0.002). The hospital stay was shorter in the post-training group (11 [standard deviation (SD) 7] v. 23 [SD 45] d, p = 0.03). The median survival was higher in the post-training group (47 v. 29 mo, p = 0.03). Conclusion: These results suggest that a short-course technical training in D2 lymphadenectomy, completed in Japan, improved lymph node sampling, decreased postoperative complications and improved survival of patients undergoing surgery for gastric cancer in a Western setting.

scholarly journals Prognostic performance of three lymph node staging systems in patients after D2 lymphadenectomy for gastric cancer

2020 ◽  
Author(s):  
Ze-ping Huang ◽  
Wen-jun Zhang ◽  
Zi-xian Wang ◽  
Hai-peng Liu ◽  
Xiang-Ting Zeng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Optimal System ◽  
Ca 125 ◽  
D2 Lymphadenectomy ◽  
Concordance Index ◽  
Internal Validation ◽  
Preoperative Serum ◽  
Staging Systems ◽  
Resectable Gastric Cancer

Background: Accurate staging of lymph node (LN) status is essential for predicting prognosis in patients with gastric cancer. Recent proposals suggest that lymph node ratio (LNR) and log odds of metastatic lymph nodes (LODDS) may have superior accuracy in predicting survival by minimizing stage migration. The aim of the present study was to compare the prognostic performances of the UICC (pN), LNR and LODDS staging systems and incorporate the optimal system into a nomogram for predicting individual survival in patients with resectable gastric cancer. Methods: The study cohort comprised of 423 patients who had undergone D2 lymphadenectomy. The discriminatory powers of the different LN staging systems were compared using the concordance index (C-index). The optimal system was incorporated into a prognostic nomogram with other independent prognosticators, and bootstrap validation was performed. Results: When LN status was assessed as a continuous variable, the LNR system (C-index: 0.712) was superior to pN (C-index: 0.695) and LODDS (C-index: 0.704). Age, LNR, and preoperative serum CA 19-9 and CA 125 were incorporated into a nomogram for predicting 2-year overall survival. Internal validation of the nomogram revealed good predictive abilities, with a bootstrap-corrected concordance index of 0.704. Conclusion: Overall, LNR was the optimum predicator of survival in patients with resectable gastric cancer on the basis of LN status. LNR was incorporated into a nomogram along with age and preoperative serum CA 19-9 and CA 125. Internal validation confirmed the predictive ability of this nomogram.

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

scholarly journals Laparoscopic infrapyloric lymph nodes dissection through the right bursa omentalis approach for gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun Yang ◽  
Wei-Han Zhang ◽  
Kai Liu ◽  
Xin-Zu Chen ◽  
Xiao-Long Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Laparoscopic Gastrectomy ◽  
Operation Time ◽  
D2 Lymphadenectomy ◽  
Estimated Blood Loss ◽  
Bursa Omentalis ◽  
The Mean ◽  
Infrapyloric Lymph Nodes ◽  
The Right

Abstract Background A complete dissection of infrapyloric lymph nodes is the key to a curative gastrectomy, which can be sometimes technically challenging in laparoscopic surgery. Methods One hundred and eighteen patients with gastric cancer undergoing laparoscopic gastrectomy with D2 lymphadenectomy in which the infrapyloric lymph nodes were dissected through the right bursa omentalis approach were included. The clinicopathologic characteristics and surgical outcomes were analyzed retrospectively. Results The laparoscopic gastrectomy with D2 lymphadenectomy was successful in all 118 patients with no open conversion. The mean operation time was 246.6 ± 45.7 min. The mean estimated blood loss was 87.0 ± 35.9 mL. Postoperative complications occurred in 17.8% of the patients, which were treated successfully with conservative therapy or aspiration in all. There were no No.6 lymphadenectomy-associated complications, such as injury of transverse colon, vessels of mesocolon, pancreas or duodenum, no pancreatitis, pancreatic leakage or postoperative hemorrhage. The mean postoperative hospital stay was 9.6 ± 3.7 days. On average, the total lymph nodes harvested were 36.8 ± 12.9, in which the ones from the infrapyloric area were 5.1 ± 3.1. Conclusion Laparoscopic dissection of infrapyloric lymph nodes through the right bursa omentalis approach seems to be feasible and safe, facilitating a more complete No.6 lymphadenectomy for gastric cancer.

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