Skip to main content

Advertisement

SpringerLink
Log in

A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition

  • How to Do It
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Surgery for gastric remnant cancer after distal gastrectomy is well established; however, little is known about the removal of remnant gastric cancer following proximal gastrectomy with jejunal interposition. We introduce a surgical technique for removing remnant cancer under these circumstances. We used this technique to remove a total gastric remnant with radical lymph node dissection, while preserving the interposed jejunum for easy re-reconstruction by Roux-en-Y anastomosis, in five patients. The median operating time was 199 min and the median blood loss was 330 ml. There were no postoperative deaths or major complications and all five patients were discharged within 14 days after surgery. Our technique for total resection of the gastric remnant after proximal gastrectomy and re-reconstruction with preserved interposed jejunum is easy, safe, and effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Katai H, Sano T, Fukagawa T, Shinohara H, Sasako M. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg. 2003;90:850–3.

    Article  PubMed  CAS  Google Scholar 

  2. Katai H, Morita S, Saka M, Taniguchi H, Fukagawa T. Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach. Br J Surg. 2010;97:558–62.

    Article  PubMed  CAS  Google Scholar 

  3. Kitamura K, Yamaguchi T, Nishida S, Yamamoto K, Ichikawa D, Okamoto K, et al. The operative indications for proximal gastrectomy in patients with gastric cancer in the upper third of the stomach. Surg Today. 1997;27:993–8.

    Article  PubMed  CAS  Google Scholar 

  4. Kitano S, Adachi Y, Shiraishi N, Suematsu T, Bando T. Laparoscopic-assisted proximal gastrectomy for early gastric carcinomas. Surg Today. 1999;29:389–91.

    Article  PubMed  CAS  Google Scholar 

  5. Tokunaga M, Ohyama S, Hiki N, Hoshino E, Nunobe S, Fukunaga T, et al. Endoscopic evaluation of reflux esophagitis after proximal gastrectomy: comparison between esophagogastric anastomosis and jejunal interposition. World J Surg. 2008;32:1473–7.

    Article  PubMed  Google Scholar 

  6. Nozaki I, Kurita A, Nasu J, Kubo Y, Aogi K, Tanada M, et al. Higher incidence of gastric remnant cancer after proximal than distal gastrectomy. Hepatogastroenterology. 2007;54:1604–8.

    PubMed  Google Scholar 

  7. Ohyama S, Tokunaga M, Hiki N, Fukunaga T, Fujisaki J, Seto Y, et al. A clinicopathological study of gastric stump carcinoma following proximal gastrectomy. Gastric Cancer. 2009;12:88–94.

    Article  PubMed  Google Scholar 

  8. Nunobe S, Ohyama S, Miyata S, Matsuura M, Hiki N, Fukunaga T, et al. Incidence of gastric cancer in the remnant stomach after proximal gastrectomy. Hepatogastroenterology. 2008;55:1855–8.

    PubMed  Google Scholar 

  9. Nozaki I, Nasu J, Kubo Y, Tanada M, Nishimura R, Kurita A. Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery. World J Surg. 2010;34:1548–54.

    Article  PubMed  Google Scholar 

  10. Japanese Gastric Cancer A. Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10–24.

  11. Sinning C, Schaefer N, Standop J, Hirner A, Wolff M. Gastric stump carcinoma - epidemiology and current concepts in pathogenesis and treatment. Eur J Surg Oncol. 2007;33:133–9.

    Article  PubMed  CAS  Google Scholar 

  12. Tanigawa N, Nomura E, Lee SW, Kaminishi M, Sugiyama M, Aikou T, et al. Current state of gastric stump carcinoma in Japan: based on the results of a nationwide survey. World J Surg. 2010;34:1540–7.

    Article  PubMed  Google Scholar 

  13. Sasako M, Maruyama K, Kinoshita T, Okabayashi K. Surgical treatment of carcinoma of the gastric stump. Br J Surg. 1991;78:822–4.

    Article  PubMed  CAS  Google Scholar 

  14. Thorban S, Bottcher K, Etter M, Roder JD, Busch R, Siewert JR. Prognostic factors in gastric stump carcinoma. Ann Surg. 2000;231:188–94.

    Article  PubMed  CAS  Google Scholar 

  15. Han SL, Hua YW, Wang CH, Ji SQ, Zhuang J. Metastatic pattern of lymph node and surgery for gastric stump cancer. J Surg Oncol. 2003;82:241–6.

    Article  PubMed  Google Scholar 

  16. Kunisaki C, Shimada H, Nomura M, Hosaka N, Akiyama H, Ookubo K, et al. Lymph node dissection in surgical treatment for remnant stomach cancer. Hepatogastroenterology. 2002;49:580–4.

    PubMed  Google Scholar 

  17. Yonemura Y, Ninomiya I, Tsugawa K, Masumoto H, Takamura H, Fushida S, et al. Lymph node metastases from carcinoma of the gastric stump. Hepatogastroenterology. 1994;41:248–52.

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

Isao Nozaki and his co-authors have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Gastroenterology, National Hospital Organization Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan

    Isao Nozaki, Shinji Hato & Akira Kurita

Authors
  1. Isao Nozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shinji Hato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akira Kurita
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Isao Nozaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nozaki, I., Hato, S. & Kurita, A. A new technique for resecting gastric remnant cancer after proximal gastrectomy with jejunal interposition. Surg Today 42, 1135–1138 (2012). https://doi.org/10.1007/s00595-012-0212-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-012-0212-y

Keywords

Search

Navigation