Laparoscopic Mesogastrium Excision for Gastric Cancer: Only the Beginning.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Gastric cancer surgery, chemotherapy, and radiotherapy offer the only curative potential.
• High local recurrence rates remain a significant challenge in gastric cancer treatment.

Purpose of the Study:

• To systematically review the literature on Mesogastrium Excision (MGE) in gastric cancer surgery.
• To evaluate the feasibility and outcomes of MGE, particularly during laparoscopic D2 lymphadenectomy.

Main Methods:

• Systematic literature search of PubMed, EMBASE, and Web of Science up to March 2020.
• Inclusion of six studies with 518 patients, focusing on laparoscopic MGE cases.
• Analysis of outcomes including lymph node retrieval, operative time, morbidity, and complications.

Main Results:

• A mean of 36.7 lymph nodes were retrieved.
• Mean operative time was 240.7 minutes with 6% overall morbidity.
• Laparoscopic MGE demonstrated feasibility with low conversion rates and acceptable hospital stay.

Conclusions:

• Mesogastrium excision (MGE) is a feasible surgical option for gastric cancer with curative intent, adaptable to laparoscopic approaches.
• Further research is needed to define the precise indications for this invasive procedure.