Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gastric cancer treatment traditionally involves open surgery.
• Minimally invasive techniques like laparoscopic surgery are emerging to improve patient quality of life.
• Hand-assisted laparoscopic surgery (HALS) has shown promise for distal gastrectomies.

Purpose of the Study:

• To evaluate the efficacy and safety of HALS for total or proximal gastrectomy in upper gastric cancer.
• To assess the feasibility of HALS in performing regional lymph node dissection and anastomosis for upper gastric malignancies.

Main Methods:

• HALS was employed for total or proximal gastrectomy and lymph node dissection in 28 patients with upper gastric cancer.
• Intracorporeal esophageal anastomosis was performed using a circular stapling device (PCEEA).
• Extracorporeal jejunojejunostomy and jejunogastrostomy were completed with a hand-sewn technique via a HALS wound.

Main Results:

• The operation time and blood loss were satisfactory across all cases.
• The average number of dissected lymph nodes was comparable to open gastrectomy.
• Patients experienced minimal morbidity and demonstrated rapid postoperative recovery.

Conclusions:

• HALS is a feasible and effective minimally invasive surgical option for upper gastric cancer.
• This laparoscopic approach offers comparable oncological outcomes to open gastrectomy with reduced patient morbidity.
• HALS enhances patient recovery and quality of life in the surgical management of upper gastric malignancies.