Abstract:
BACKGROUND:Selected cases of clinical mucosal gastric cancer can be treated endoscopically. But mucosal gastric cancer, which has a higher incidence of lymph node metastasis, should be treated by gastrectomy with lymph node dissection. Laparoscopy-assisted gastrectomy is usually indicated for the surgical treatment of mucosal gastric cancer. STUDY DESIGN:From April 2005 to December 2007, 148 consecutive patients with clinical mucosal gastric cancer who underwent laparoscopy-assisted gastrectomy were investigated to clarify the clinicopathologic findings in this patient group. RESULTS:Of the patients who underwent gastrectomy, 93 (63%) had tumors>20 mm in diameter and 92 (62%) had undifferentiated cancer. The frequency of lymph node metastasis was 8% (12 patients). One patient had second-compartment lymph node metastasis (station 8a). In patients with lymph node metastasis, 11 (92%) had an ulcer scar and 11 (92%) had undifferentiated tumors. None of the patients met the criteria for extended endoscopic submucosal dissection. CONCLUSIONS:The incidence of lymph node metastasis in patients with mucosal gastric cancer in whom gastrectomy is indicated is higher than reported previously. More careful consideration is needed for the possibility of lymph node metastasis in this era of endoscopic submucosal dissection.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Yoshikawa K,Hiki N,Fukunaga T,Tokunaga M,Yamamoto Y,Miki A,Ogawa K,Higashijima J,Ohyama S,Seto Y,Shimada M,Yamaguchi Tdoi
10.1016/j.jamcollsurg.2009.02.051subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1045-50issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(09)00218-Xjournal_volume
208pub_type
杂志文章abstract:BACKGROUND:The Cognitive Changes and Retirement among Senior Surgeons (CCRASS) study suggested that although subjective cognitive awareness may play a role in surgeons' retirement decisions, self-perceived cognitive decline did not predict objective cognitive performance. This article summarizes results from all partic...
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