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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
Published on: October 31, 2025
232
Compliance to D2 lymphadenectomy in laparoscopic gastrectomy
Wietse J Eshuis1, Mark I van Berge Henegouwen2, Werner A Draaisma2,3
1Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. W.J.Eshuis@amc.uva.nl.
Updates in Surgery
|June 22, 2018
Summary
Laparoscopic gastrectomy shows comparable D2 lymphadenectomy compliance to open surgery for gastric cancer. Further trials in advanced stages are pending, but laparoscopy is viable in experienced centers.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Radical gastrectomy with D2 lymphadenectomy is standard for locally advanced gastric cancer.
- The efficacy of D2 lymphadenectomy in laparoscopic versus open surgery remains unclear.
- Current evidence primarily focuses on early-stage gastric cancer.
Purpose of the Study:
- To evaluate compliance with D2 lymphadenectomy in laparoscopic gastrectomy.
- To compare D2 lymphadenectomy adherence between laparoscopic and open gastric cancer surgery.
- To review current literature on D2 lymphadenectomy in minimally invasive gastric cancer treatment.
Main Methods:
- Systematic literature review of randomized trials and descriptive analysis.
- Focus on studies comparing laparoscopic and open gastrectomy regarding lymph node retrieval and D2 dissection adherence.
- Analysis of available data on lymph node yield and adherence to D2 guidelines.
Main Results:
- Most randomized trials address early gastric cancer, where formal D2 lymphadenectomy is often not required.
- Studies generally report no significant differences in the number of retrieved lymph nodes between laparoscopic and open gastrectomy.
- One trial specifically assessing adherence to D2 lymphadenectomy found no difference between surgical approaches.
Conclusions:
- Current evidence suggests comparable D2 lymphadenectomy compliance between laparoscopic and open gastrectomy.
- Further randomized trials are needed, particularly for advanced gastric cancer.
- Laparoscopic gastrectomy with D2 lymphadenectomy is a feasible option in experienced surgical centers.
