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Surgery Today
Published in: Surgery Today 5/2017

01-05-2017 | Review Article

Laparoscopic proximal gastrectomy for early gastric cancer

Authors: Yoshitake Ueda, Hidehumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata, Norio Shiraishi

Published in: Surgery Today | Issue 5/2017

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Abstract

The incidence of proximal early gastric cancer (EGC) is increasing, and while laparoscopic proximal gastrectomy (LPG) has been performed as a surgical option, it is not yet the standard treatment, because there is no established common reconstruction method following proximal gastrectomy (PG). We reviewed the English-language literature to clarify the current status and problems associated with LPG in treating proximal EGC. This procedure is considered indicated for EGC located in the upper third of the stomach with clinical T1N0, but not when it can be treated endoscopically. No operative mortality or conversion to open surgery was reported in our review, suggesting that this procedure is technically feasible. The most frequent postoperative complication involved problems with anastomoses, possibly caused by the technical complexity of the reconstruction. Although various reconstruction methods following open PG (OPG) and LPG have been reported, there is no standard reconstruction method. Well-designed multicenter, randomized, controlled, prospective trials to evaluate the various reconstruction methods are necessary.
Literature
1.
Ahn HS, Lee HJ, Yoo MW, Jeong SH, Park DJ, Kim HH, et al. Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period. Br J Surg. 2011;98:255–60.CrossRefPubMed
2.
Jeong O, Park Y-K. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer. 2011;11:69–77.CrossRefPubMedPubMedCentral
3.
Sano T, Hollowood K. Early gastric cancer: diagnosis and less invasive treatments. Scand J Surg. 2006;95:249–55.CrossRefPubMed
4.
Wen L, Chen XZ, Wu B, Chen XL, Wang L, Yang K, et al. Total vs. proximal gastrectomy for proximal gastric cancer: a systematic review and meta-analysis. Hepatogastroenterology. 2012;59:633–40.PubMed
5.
Adachi Y, Inoue T, Hagino Y, Shiraishi N, Shimoda K, Kitano S. Surgical results of proximal gastrectomy for early-stage gastric cancer: jejunal interposition and gastric tube reconstruction. Gastric Cancer. 1999;2:40–5.CrossRefPubMed
6.
Takeshita K, Saito N, Saeki I, Honda T, Tani M, Kando F, et al. Proximal gastrectomy and jejunal pouch interposition for the treatment of early cancer in the upper third of the stomach: surgical techniques and evaluation of postoperative function. Surgery. 1997;121:278–86.CrossRefPubMed
7.
Kameyama J, Ishida H, Yasaku Y, Suzuki A, Kuzu H, Tsukamoto M. Proximal gastrectomy reconstructed by interposition of a jejunal pouch. Surgical technique. Eur J Surg. 1993;159:491–3.PubMed
8.
Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.PubMed
9.
Tanimura S, Higashino M, Fukunaga Y, Takemura M, Tanaka Y, Fujiwara Y, et al. Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases. Surg Endosc. 2005;19:1177–81.CrossRefPubMed
10.
Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer. 2006;9:167–76.CrossRefPubMed
11.
Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group. A multi-center study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.CrossRefPubMedPubMedCentral
12.
Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008;248:721–7.CrossRefPubMed
13.
Cai J, Wei D, Gao CF, Zhang CS, Zhang H, Zhao T. A prospective randomized study comparing open versus laparoscopy-assisted D2 radical gastrectomy in advanced gastric cancer. Dig Surg. 2011;28:331–7.CrossRefPubMed
14.
Hu Y, Ying M, Huang C, Wei H, Jiang Z, Peng X, et al. Oncologic outcomes of laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective cohort study from China. Surg Endosc. 2014;28:2048–56.CrossRefPubMed
15.
Fang C, Hua J, Li J, Zhen J, Wang F, Zhao Q, et al. Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymphadenectomy for advanced gastric cancer. Am J Surg. 2014;208:391–6.CrossRefPubMed
16.
Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer. Surgery. 1998;123:127–30.CrossRefPubMed
17.
Katai H, Sano T, Fukagawa T, Shinohara H, Sasako M. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg. 2003;90:850–3.CrossRefPubMed
18.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.CrossRef
19.
Kamikawa Y, Kobayashi T, Kamiyama, Satomoto K. A new procedure of esophagogastrostomy to prevent reflux following proximal gastrectomy. Shoukakigeka. 2001;24:1053–60 (in Japanese).
20.
Kitano S, Adachi Y, Shiraishi N, Suematsu T, Bando T. Laparoscopy-assisted proximal gastrectomy for early gastric carcinomas. Surg Today. 1999;29:389–91.CrossRefPubMed
21.
Kinoshita T, Gotohda N, Kato Y, Takahashi S, Konishi M, Kinoshita T. Laparoscopic proximal gastrectomy with jejunal interposition for gastric cancer in the proximal third of the stomach: a retrospective comparison with open surgery. Surg Endosc. 2013;27:146–53.CrossRefPubMed
22.
Japan Society for Endoscopic Surgery. Nationwide survey on endoscopic surgery in Japan. J Jpn Soc Endosc Surg. 2014;5:535–40 (in Japanese).
23.
Takeuchi H, Oyama T, Kamiya S, Nakamura R, Takahashi T, Wada N, et al. Laparoscopy-assisted proximal gastrectomy with sentinel node mapping for early gastric cancer. World J Surg. 2011;35:2463–71.CrossRefPubMed
24.
Ahn SH, Lee JH, do Park J, Kim HH. Comparative study of clinical outcomes between laparoscopy-assisted proximal gastrectomy (LAPG) and laparoscopy-assisted total gastrectomy (LATG) for proximal gastric cancer. Gastric Cancer. 2013;16:282–9.CrossRefPubMed
25.
Kim DJ, Lee JH, Kim W. Lower esophageal sphincter-preserving laparoscopy-assisted proximal gastrectomy in patients with early gastric cancer: a method for the prevention of reflux esophagitis. Gastric Cancer. 2013;16:440–4.CrossRefPubMed
26.
Kurihara N, Kubota T, Otani Y, Ohgami M, Kumai K, Sugiura H, et al. Lymph node metastasis of early gastric cancer with submucosal invasion. Br J Surg. 1998;85:835–9.CrossRefPubMed
27.
Kwon SJ. Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group. World J Surg. 1997;21:837–44.CrossRefPubMed
28.
Kitamura K, Yamaguchi T, Nishida S, Yamamoto K, Ichikawa D, Okamoto K, et al. The operative indications for proximal gastrectomy in patients with gastric cancer in the upper third of the stomach. Surg Today. 1997;27:993–8.CrossRefPubMed
29.
Monig SP, Collet PH, Baldus SE, Schmackpfeffer K, Schroder W, Thiele J, et al. Splenectomy in proximal gastric cancer: frequency of lymph node metastasis to the splenic hilus. J Surg Oncol. 2001;76:89–92.CrossRefPubMed
30.
Shin SH, Jung H, Choi SH, An JY, Choi MG, Noh JH, et al. Clinical significance of splenic hilar lymph node metastasis in proximal gastric cancer. Ann Surg Oncol. 2009;16:1304–9.CrossRefPubMed
31.
Sano T, Aiko T. New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer. 2011;14:97–100.CrossRefPubMed
32.
Nakamura M, Yamaue H. Reconstruction after proximal gastrectomy for gastric cancer in the upper third of the stomach: a review of the literature published from 2000 to 2014. Surg Today. 2016;46:517–27.CrossRefPubMed
33.
Aihara R, Mochiki E, Ohno T, Yanai M, Toyomasu Y, Ogata K, et al. Laparoscopy-assisted proximal gastrectomy with gastric tube reconstruction for early gastric cancer. Surg Endosc. 2010;24:2343–8.CrossRefPubMed
34.
Yasuda A, Yasuda T, Imamoto H, Kato H, Nishiki K, Iwama M, et al. A newly modified esophagogastrostomy with a reliable angle of His by placing a gastric tube in the lower mediastinum in laparoscopy-assisted proximal gastrectomy. Gastric Cancer. 2014 (Epub ahead of print).
35.
Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, et al. Laparoscopic esophagogastric circular stapled anastomosis: a modified technique to protect the esophagus. Gastric Cancer. 2007;10:181–6.CrossRefPubMed
36.
Jung YJ, Kim DJ, Lee JH, Kim W. Safety of intracorporeal circular stapling esophagojejunostomy using trans-orally inserted anvil (OrVil) following laparoscopic total or proximal gastrectomy—comparison with extracorporeal anastomosis. World J Surg Oncol. 2013;11:209.CrossRefPubMedPubMedCentral
37.
Hirahara N, Monma H, Shimojo Y, Matsubara T, Hyakudomi R, Yano S, et al. Reconstruction of the esophagojejunostomy by double stapling method using EEA OrVil in laparoscopic total gastrectomy and proximal gastrectomy. World J Surg Oncol. 2011;9:55.CrossRefPubMedPubMedCentral
38.
Uyama I, Sugioka A, Matsui H, Fujita J, Komori Y, Hatakawa Y, et al. Laparoscopic side-to-side esophagogastrostomy using a linear stapler after proximal gastrectomy. Gastric Cancer. 2001;4:98–102.CrossRefPubMed
39.
Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, et al. Clinical experience of laparoscopy-assisted proximal gastrectomy with toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg. 2009;209:344–51.CrossRefPubMed
40.
Tsujimoto H, Uyama I, Yaguchi Y, Kumano I, Takahata R, Matsumoto Y, et al. Outcome of overlap anastomosis using a linear stapler after laparoscopic total and proximal gastrectomy. Langenbecks Arch Surg. 2012;397:833–40.CrossRefPubMed
41.
Okabe H, Obama K, Tanaka E, Tsunoda S, Akagami M, Sakai Y. Laparoscopic proximal gastrectomy with a hand-sewn esophago-gastric anastomosis using a knifeless endoscopic linear stapler. Gastric Cancer. 2013;16:268–74.CrossRefPubMed
42.
Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A. Completely laparoscopic proximal gastrectomy with jejunal interposition and lymphadenectomy. J Am Coll Surg. 2000;191:114–9.CrossRefPubMed
43.
Ahn SH, Jung do H, Son SY, Lee CM, Park do J, Kim HH. Laparoscopic double-tract proximal gastrectomy for proximal early gastric cancer. Gastric Cancer. 2014;17:562–70.CrossRefPubMed
44.
Nomura E, Lee SW, Kawai M, Yamazaki M, Nabeshima K, Nakamura K, et al. Functional outcomes by reconstruction technique following laparoscopic proximal gastrectomy for gastric cancer: double tract versus jejunal interposition. World J Surg Oncol. 2014;12:20.CrossRefPubMedPubMedCentral
45.
Kim J, Kim S, Min YD. Consideration of cardia preserving proximal gastrectomy in early gastric cancer of upper body for prevention of gastroesophageal reflux disease and stenosis of anastomosis site. J Gastric Cancer. 2012;12:187–93.CrossRefPubMedPubMedCentral
46.
Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed
47.
Tanimura S, Higashino M, Fukunaga Y, Kishida S, Ogata A, Fujiwara Y, et al. Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer. Br J Surg. 2007;94:204–7.CrossRefPubMed
48.
An JY, Youn HG, Choi MG, Noh JH, Sohn TS, Kim S. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg. 2008;196:587–91.CrossRefPubMed
49.
Yoo CH, Sohn BH, Han WK, Pae WK. Long-term results of proximal and total gastrectomy for adenocarcinoma of the upper third of the stomach. Cancer Res Treat. 2004;36:50–5.CrossRefPubMedPubMedCentral
50.
Katai H, Morita S, Saka M, Taniguchi H, Fukagawa T. Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach. Br J Surg. 2010;97:558–62.CrossRefPubMed
51.
An JY, Youn HG, Choi MG, Noh JH, Sohn TS, Kim S. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg. 2008;196:587–91.CrossRefPubMed
52.
Hosogi H, Yoshimura F, Yamaura T, Satoh S, Uyama I, Kanaya S. Esophagogastric tube reconstruction with stapled pseudo-fornix in laparoscopic proximal gastrectomy: a novel technique proposed for Siewert type II tumors. Langenbecks Arch Surg. 2014;399:517–23.CrossRefPubMed
53.
Shiraishi N, Adachi Y, Kitano S, Kakisako K, Inomata M, Yasuda K. Clinical outcome of proximal versus total gastrectomy for proximal gastric cancer. World J Surg. 2002;26:1150–4.CrossRefPubMed
54.
Shiraishi N, Hirose R, Morimoto A, Kawano K, Adachi Y, Kitano S. Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy. Gastric Cancer. 1998;1:78–9.CrossRefPubMed
55.
Iwata T, Kurita N, Ikemoto T, Nishioka M, Andoh T, Shimada M. Evaluation of reconstruction after proximal gastrectomy: prospective comparative study of jejunal interposition and jejunal pouch interposition. Hepatogastroenterology. 2006;53:301–3.PubMed
56.
Ichikawa D, Komatsu S, Okamoto K, Shiozaki A, Fujiwara H, Otsuji E. Esophagogastrostomy using a circular stapler in laparoscopy-assisted proximal gastrectomy with an incision in the left abdomen. Langenbecks Arch Surg. 2012;397:57–62.CrossRefPubMed
57.
Braga M, Zuliani W, Foppa L, Di Carlo V, Cristallo M. Food intake and nutritional status after total gastrectomy: results of a nutritional follow-up. Br J Surg. 1988;75:477–80.PubMed
58.
Bergh C, Sjostedt S, Hellers G, Zandian M, Sodersten P. Meal size, satiety and cholecystokinin in gastrectomized humans. Physiol Behav. 2003;78:143–7.CrossRefPubMed
Metadata
Title
Laparoscopic proximal gastrectomy for early gastric cancer
Authors
Yoshitake Ueda
Hidehumi Shiroshita
Tsuyoshi Etoh
Masafumi Inomata
Norio Shiraishi
Publication date
01-05-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 5/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1401-x

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