title: Editorial comment: feasibility of central gastrectomy for gastric cancer.
abstract: BACKGROUND
  Central gastrectomy (CG) for gastric cancer was developed to preserve pyloric function and maintain a large gastric volume. Whether this procedure is feasible for limited cases of gastric cancer is unclear.
  
  
  METHODS
  On the basis of Union Internationale Contre le Cancer TNM classification, pathologic characteristics, perioperative parameters, and long-term results, we analyzed 100 patients who underwent CG.
  
  
  RESULTS
  Pathologic findings included T1 (tumor depth, mucosal or submucosal) in 82 patients and T2 (muscularis propria or subserosal) in 18 patients. Mean number of dissected lymph nodes was 17.3, and pathologic N1 (node metastasis, 6 or less) was found in 14 patients. There were no operative deaths, but 5 patients had postoperative complications: anastomotic leakage in 1, severe gastric stasis in 2, ischemic gastric ulcer in 1, and intra-abdominal bleeding in 1. No patient had a cancer recurrence in a mean follow-up of 49 months. New early gastric cancer was detected in 3 patients during follow-up endoscopic examination. The 5-year cumulative survival was 0.97. One year after CG, 63 patients had early satiety after food intake. Mean ratio of 1-year postoperative/preoperative body weight was 95%.
  
  
  CONCLUSIONS
  Central gastrectomy with sufficient node dissection resulted in good long-term survival and minimal postoperative weight loss. CG is a safe and useful procedure for selected patients with gastric cancer, although close follow-up for recurrence and a more precise analysis on physiologic states is needed.
authors.forename: Jouji
authors.initials: J
authors.lastname: Iseki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Takagi
authors.forename: Kazushige
authors.initials: K
authors.lastname: Touyama
authors.forename: Keiji
authors.initials: K
authors.lastname: Sano
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakagami
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ori
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ooba
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kin
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kojima
authors.forename: Koichi
authors.initials: K
authors.lastname: Kojima
mesh_terms: D016063:Blood Loss, Surgical; D013505:Digestive System Surgical Procedures / Q000379:methods; D004435:Eating; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D009017:Morbidity; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate