Authors: Keisuke Koeda Satoshi Nishizuka Go Wakabayashi
Publish Date: 2011/04/08
Volume: 35, Issue: 7, Pages: 1469-1477
Abstract
Laparoscopyassisted distal gastrectomy for gastric cancer was first reported by Kitano et al in 1991 Laparoscopic wedge resection LWR and intragastric mucosal resection IGMR were quickly adapted for gastric cancer limited to the mucosal layer and having no risk of lymph node metastasis Following improvements in endoscopic mucosal resection EMR and endoscopic submucosal dissection ESD the use of LWR and IGMR for these indications decreased and patients with gastric cancer including those with a risk of lymph node metastases were more likely to be managed with laparoscopic gastrectomy LG with lymph node dissection Many retrospective comparative trials and randomizedcontrolled trials RCT have confirmed that LG is safe and feasible and that shortterm outcomes are better than those of open gastrectomy OG in patients with early gastric cancer EGC However these trials did not include a satisfactory number of patients to establish clinical evidence Thus additional multicenter randomizedcontrolled trials are needed to delineate significantly quantifiable differences between LG and OG As laparoscopic experience has accumulated the indications for LG have been broadened to include older and overweight patients and those with advanced gastric cancer Moreover advanced techniques such as laparoscopyassisted total gastrectomy laparoscopyassisted proximal gastrectomy laparoscopyassisted pyloruspreserving gastrectomy PPG and extended lymph node dissection D2 have been widely performed
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