title: Totally laparoscopic 95% gastrectomy for cancer: technical considerations.
abstract: BACKGROUND
  Total gastrectomy is the standard treatment for tumours arising in the proximal stomach and for diffuse cancer according to the Lauren classification. Laparoscopic approach is progressively accepted and provides encouraging results. In order to reduce complications associated to the esophago-jejunal anastomosis, the concept of the 95 % open gastrectomy was developed in Japan, in the early 1980s. This procedure provides the spearing of a small remnant gastric stump of 2 cm and allows performing a gastro-jejunal anastomosis. Unlike the 7/8 gastrectomy, the 95 % gastrectomy allows the complete resection of the gastric fundus and an optimized pericardial lymph node dissection (group 1 and 2). We herein describe, step-by-step, our technique of full laparoscopic 95 % gastrectomy (G95 %), with D2 lymphadenectomy, including complete lymphadenectomy of the cardial nodes.
  
  
  CONCLUSIONS
  When it is possible to respect the oncologic criteria regarding proximal resection margin, 95 % gastrectomy would offer best short-term results, such as lower anastomotic leak rate and a better quality of life, limiting the effect of disruption of the eso-gastric junction.
  
  
  CONCLUSIONS
  In selected patients, laparoscopic G95 % is feasible and safe; it could be performed without any additional technical difficulties. Controlled clinical trials are necessary to confirm the encouraging results of the cases series, recently reported in literature.
authors.affiliation: Service de Chirurgie Générale et Mininvasive, Centre Hospitalier de Luxembourg, U26 4 rue Barblé, 1210, Luxembourg, Luxembourg, lucaarrumd@gmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Arru
authors.forename: Juan Santiago
authors.initials: JS
authors.lastname: Azagra
authors.forename: Olivier
authors.initials: O
authors.lastname: Facy
authors.forename: Silviu Tiberiu
authors.initials: ST
authors.lastname: Makkai-Popa
authors.forename: Virginie
authors.initials: V
authors.lastname: Poulain
authors.forename: Martine
authors.initials: M
authors.lastname: Goergen
mesh_terms: D000714:Anastomosis, Surgical; D004322:Drainage; D005743:Gastrectomy / Q000379:methods*; D018530:Gastric Stump / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D056888:Patient Positioning; D013274:Stomach Neoplasms / Q000601:surgery*