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Consideration of cardia preserving proximal gastrectomy in early gastric cancer of upper body for prevention of gastroesophageal reflux disease and stenosis of anastomosis site.

Kim J, Kim S, Min YD - J Gastric Cancer (2012)

Bottom Line: The length of proximal resection free margin was 3.1±0.1 cm and distal was 3.7±0.1 cm.Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication).Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chosun University College of Medicine, Gwangju, Korea.

ABSTRACT

Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third.

Materials and methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined.

Results: There were 5 males and 5 females. The mean age was 56.5±0.5 years. The mean operation time was 188.5±0.5 minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was 25.2±0.5. The length of proximal resection free margin was 3.1±0.1 cm and distal was 3.7±0.1 cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom.

Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

No MeSH data available.


Related in: MedlinePlus

Endoscopic finding of early gastric cancer of upper body near esophagogastric junction.
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Figure 1: Endoscopic finding of early gastric cancer of upper body near esophagogastric junction.

Mentions: The patients under the CPPG were limited to those who were diagnosed as early gastric cancer, based on the endoscopic results with no lymph node hypertrophy on the CT located on the top 4 cm from the esophago-gastric junction (E-G junction) (Fig. 1). This is because the cardia with 2 cm size from E-G junction shall be preserved, and the excision shall be performed by securing the proximal free resection margin of more than 2 cm. After omentectomy, to preserve the right gastroepiploic artery, we checked the 6th lymph node with fingers without enbloc dissection. It was confirmed that no metastasis occurred by performing frozen biopsy for the dissected lymph nodes and the greater omentum was dissected toward the spleen to remove all the 4th lymph nodes and the gastroepiploic vessels were dissected on 2/3 from the top to the bottom of the greater curvature, to remove the greater omentum, and divided the short gastric vessels to separate the fundus ventriculi from the spleen.


Consideration of cardia preserving proximal gastrectomy in early gastric cancer of upper body for prevention of gastroesophageal reflux disease and stenosis of anastomosis site.

Kim J, Kim S, Min YD - J Gastric Cancer (2012)

Endoscopic finding of early gastric cancer of upper body near esophagogastric junction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473226&req=5

Figure 1: Endoscopic finding of early gastric cancer of upper body near esophagogastric junction.
Mentions: The patients under the CPPG were limited to those who were diagnosed as early gastric cancer, based on the endoscopic results with no lymph node hypertrophy on the CT located on the top 4 cm from the esophago-gastric junction (E-G junction) (Fig. 1). This is because the cardia with 2 cm size from E-G junction shall be preserved, and the excision shall be performed by securing the proximal free resection margin of more than 2 cm. After omentectomy, to preserve the right gastroepiploic artery, we checked the 6th lymph node with fingers without enbloc dissection. It was confirmed that no metastasis occurred by performing frozen biopsy for the dissected lymph nodes and the greater omentum was dissected toward the spleen to remove all the 4th lymph nodes and the gastroepiploic vessels were dissected on 2/3 from the top to the bottom of the greater curvature, to remove the greater omentum, and divided the short gastric vessels to separate the fundus ventriculi from the spleen.

Bottom Line: The length of proximal resection free margin was 3.1±0.1 cm and distal was 3.7±0.1 cm.Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication).Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chosun University College of Medicine, Gwangju, Korea.

ABSTRACT

Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third.

Materials and methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined.

Results: There were 5 males and 5 females. The mean age was 56.5±0.5 years. The mean operation time was 188.5±0.5 minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was 25.2±0.5. The length of proximal resection free margin was 3.1±0.1 cm and distal was 3.7±0.1 cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom.

Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

No MeSH data available.


Related in: MedlinePlus