Preoperative endoscopic tattooing using India ink to determine the resection margins during totally laparoscopic distal gastrectomy for gastric cancer.

Abstract:

PURPOSE:This study was conducted to determine whether establishing the proximal resection line using India ink tattooing can ensure safe resection margins during totally laparoscopic distal gastrectomy. METHODS:This retrospective study included 81 patients who underwent totally laparoscopic distal gastrectomy for gastric cancer on the lower two-thirds of the stomach. The proximal resection margins were analyzed with respect to the macroscopic type and clinical T stage, and the intraoperative appearance of the stain on the serosa was classified by reviewing surgical videos. RESULTS:R0 resection was performed in all patients. The rates of the intended margins were 89.2% in patients without a frozen section diagnosis and 84.2% in patients with differentiated type lesions who underwent a frozen section diagnosis; however, most patients with undifferentiated advanced lesions failed to achieve the intended resection margins. Intraoperative appearance revealed that 85.2% of patients had localized type stains, whereas 11.1% had widespread-type stains. CONCLUSIONS:Our procedure to determine the proximal resection line in totally laparoscopic distal gastrectomy is oncologically safe. However, careful observation of the resected specimen and a frozen section analysis should be performed for undifferentiated advanced lesions.

journal_name

Surg Today

journal_title

Surgery today

authors

Yamazaki Y,Kanaji S,Takiguchi G,Urakawa N,Hasegawa H,Yamamoto M,Matsuda Y,Yamashita K,Matsuda T,Oshikiri T,Nakamura T,Suzuki S,Kakeji Y

doi

10.1007/s00595-020-02057-9

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

111-117

issue

1

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-020-02057-9

journal_volume

51

pub_type

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