Transectional gastrectomy: an old but renewed concept for early gastric cancer.

Abstract:

:Segmental resection of the stomach was first described at the end of the 19th century by Mikulicz, who devised it to preserve the pylorus when performing gastric ulcer surgery. Although this technique was abandoned because of delayed gastric emptying, in 1967 Maki et al. developed a new improved concept of segmental gastrectomy: pylorus-preserving gastrectomy (PPG). The dramatic decrease in the occurrence of gastric ulcers limited the opportunity to perform these operations; however, PPG was then used for treating early gastric cancer, the incidence of which has increased remarkably over the last two decades. From the viewpoint of surgical oncology, a rationale to justify reducing the range of lymphadenectomy is required for preserving the curability. Therefore, we devised a new technique of transectional gastrectomy using sentinel node navigation for early gastric cancer located in the middle third of the stomach. The results of a questionnaire about postoperative symptoms and endoscopic assessment indicated the superiority of transectional gastrectomy over conventional distal gastrectomy. Future confirmation of the sentinel node concept through a multi-institutional validation study conducted by the Japanese Society of Sentinel Node Navigation Surgery would lead to widespread adoption of transectional gastrectomy.

journal_name

Surg Today

journal_title

Surgery today

authors

Fujimura T,Fushida S,Kayahara M,Ohta T,Kinami S,Miwa K

doi

10.1007/s00595-009-4151-1

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

398-403

issue

5

eissn

0941-1291

issn

1436-2813

journal_volume

40

pub_type

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