Long-term outcome after laparoscopic wedge resection for early gastric cancer.
BACKGROUND
Laparoscopic wedge resection (LWR) can be applied for the management of early gastric cancer without the risk of lymph node metastasis. Although LWR for early gastric cancer is one of the minimally invasive procedures, its radicality in cancer therapy is controversial. This study aimed to evaluate the long-term outcomes after LWR.


METHODS
Data on 43 consecutive cases of LWR performed for preoperatively diagnosed mucosal gastric cancer were analyzed retrospectively in terms of long-term outcomes.


RESULTS
No postoperative deaths occurred after LWR. Histologically, resected specimens showed submucosal invasion in 11 cases (26%) and positive surgical margins for cancer in 4 cases (9%). Three patients (7%) showed local recurrence near the staple line, and one patient (2%) died due to the local recurrence, but no lesional lymph node or distant recurrence occurred. The overall 5-year survival rate was 88%. The gastric remnant after LWR developed metachronous multiple gastric cancer in five cases (12%).


CONCLUSIONS
The findings show a relatively high incidence of positive surgical margin, local recurrence, and gastric remnant cancer after LWR. Although LWR can be performed for properly selected patients, periodic postoperative endoscopic examination is necessary to detect metachronous multiple gastric cancer and local recurrences.
Nozaki
Isao
I
Department of Surgery, Shikoku Cancer Center, 160 Kou Minami-umemoto, Matsuyama, 791-0280, Japan.
Kubo
Yoshirou
Y
Kurita
Akira
A
Tanada
Minoru
M
Yokoyama
Nobuji
N
Takiyama
Wataru
W
Takashima
Shigemitsu
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods* / Q000706:statistics & numerical data; D018530:Gastric Stump / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome