Surgical Considerations in the Management of Gastric Adenocarcinoma.
Since Theodor Billroth and César Roux perfected the methods of postgastrectomy reconstruction in as early as the late nineteenth century, surgical management of gastric cancer has made incremental progress. The longstanding and contentious debate on the optimal extent of lymph node dissection for gastric cancer seems to have settled in favor of D2 dissection. Pylorus-preserving distal (central) gastrectomy has emerged as a less invasive, function-preserving option for T1N0 middle-third gastric cancers. Frozen section analysis of margins seems partially helpful in this direction. Last, the role of palliative gastrectomy in patients with metastatic seems less important than initially thought.
Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
Eleftherios A
EA
Makris
Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA. Electronic address: gpoultsides@stanford.edu.
George A
GA
Poultsides
D000230:Adenocarcinoma / Q000601:surgery*; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D018572:Disease-Free Survival; D005629:Frozen Sections / Q000379:methods; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008488:Medical Illustration; D059351:Organ Sparing Treatments / Q000379:methods; D010166:Palliative Care / Q000379:methods; D013274:Stomach Neoplasms / Q000601:surgery*; D013536:Suture Techniques
Gastrectomy; Gastric cancer; Lymphadenectomy; Margins; Reconstruction