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Preliminary report on local resection with lymphadenectomy for early gastric cancer
1Department of Surgery, Faculty of Medicine, University of Tokyo, 3-28-6 Mejirodai Bunkyo-ku, Tokyo 112-8688, Japan.
Background:
The frequency of lymph node metastasis in mucosal gastric cancers 2-4 cm in diameter was low (three (1.3 per cent) of 234) in patients treated in this unit between 1966 and 1995. This study was a prospective report on local resection with lymphadenectomy for early gastric cancer.
Methods:
Eight patients with a single early gastric cancer underwent local resection with lymphadenectomy. The tumour was excised with a non-cancerous rim of approximately 2 cm. The extent of lymphadenectomy depended on tumour location. Intraoperative endoscopic examination and frozen-section analysis of the dissected nodes were used to determine the resection line and evaluate nodal status.
Results:
Mean operating time, blood loss and number of dissected nodes were 171 min, 87 ml and 8 respectively. There were no operative complications. Cancer invasion was confined to the mucosa in six tumours but two patients had minute submucosal invasion. The maximum diameter of the resected specimens was 10 cm and no nodal involvement was detected. No patient developed postgastrectomy syndrome.
Conclusion:
For selected patients with early gastric cancer, local resection with lymphadenectomy can provide a good quality of life without compromising cure rate.