title: Local resection of the stomach for gastric cancer.
abstract: The local resection of the stomach is an ideal method for preventing postoperative symptoms. There are various procedures for performing local resection, such as the laparoscopic lesion lifting method, non-touch lesion lifting method, endoscopic full-thickness resection, and laparoscopic endoscopic cooperative surgery. After the invention and widespread use of endoscopic submucosal dissection, local resection has become outdated as a curative surgical technique for gastric cancer. Nevertheless, local resection of the stomach in the treatment of gastric cancer in now expected to make a comeback with the clinical use of sentinel node navigation surgery. However, there are many issues associated with local resection for gastric cancer, other than the normal indications. These include gastric deformation, functional impairment, ensuring a safe surgical margin, the possibility of inducing peritoneal dissemination, and the associated increase in the risk of metachronous gastric cancer. In view of these issues, there is a tendency to regard local resection as an investigative treatment, to be applied only in carefully selected cases. The ideal model for local resection of the stomach for gastric cancer would be a combination of endoscopic full-thickness resection of the stomach using an ESD device and hand sutured closure using a laparoscope or a surgical robot, for achieving both oncological safety and preserved functions.
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan. Kinami@kanazawa-med.ac.jp.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funaki
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ueda
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
mesh_terms: D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation / Q000379:methods; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods* / Q000639:trends*; D005753:Gastric Mucosa / Q000601:surgery; D020699:Gastroscopes; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision; D011183:Postoperative Complications / Q000517:prevention & control; D000071036:Sentinel Lymph Node; D013274:Stomach Neoplasms / Q000601:surgery*; D013536:Suture Techniques
keywords: Gastric cancer; Laparoscopic endoscopic cooperative surgery; Local resection; Sentinel node