[Laparoscopic surgery for gastric cancer: indications and limitations].
Gastric cancer has been successfully treated by both endoscopic and open surgery, while early-stage gastric cancer with some risk of lymph node metastasis is managed with laparoscopic surgery. The principle of treatment of gastric cancer is to perform a complete resection of the lesion with safe and appropriate procedures based on disease stage. Three types of laparoscopic surgery have been reported: laparoscopy-assisted distal gastrectomy (LADG); laparoscopic local resection with the use of aT-fastener; and intragastric mucosal resection. In local resection, there is a possibility that past of the lesion or lymph node metastases may remain. D2 lymph node dissection requires a longer operative time and technical difficulties causing postoperative complications may be encountered. At present, LADG is the preferred choice of treatment in patients with early-stage gastric cancers due to the acceptable length of surgery and simple lymph node harvesting. For the wider application of minimally invasive surgery, numerous advances in operative procedures, including hand-assisted surgery and sentinel node navigation surgery, are required, along with technical developments for more accurate diagnosis to offer ideal treatment for each stage of gastric cancer.
Kitano
S
S
Department of Surgery I, Oita Medical University, Oita, Japan.
Yasuda
K
K
Shiraishi
N
N
Adachi
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*