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Annals of Surgical Oncology

, Volume 20, Issue 8, pp 2683–2692 | Cite as

Function-Preserving Gastrectomy for Early Gastric Cancer

  • Naoki Hiki
  • Souya Nunobe
  • Takeshi Kubota
  • Xiaohua Jiang
Gastrointestinal Oncology

Abstract

The number of early gastric cancer (EGC) cases has been increasing because of improved diagnostic procedures. Applications of function-preserving gastric cancer surgery may therefore also be increasing because of its low incidence of lymph node metastasis, excellent survival rates, and the possibility of less-invasive procedures such as laparoscopic gastrectomy being used in combination. Pylorus-preserving gastrectomy (PPG) with radical lymph node dissection is one such function-preserving procedure that has been applied for EGC, with the indications, limitations, and survival benefits of PPG already reported in several retrospective studies. Laparoscopy-assisted proximal gastrectomy has also been applied for EGC of the upper third of the stomach, although this procedure can be associated with the 2 major problems of reflux esophagitis and carcinoma arising in the gastric stump. In the patient with EGC in the upper third of the stomach, laparoscopy-assisted subtotal gastrectomy with a preserved very small stomach may provide a better quality of life for the patients and fewer postoperative complications. Finally, the laparoscopy endoscopy cooperative surgery procedure combines endoscopic submucosal dissection with laparoscopic gastric wall resection, which prevents excessive resection and deformation of the stomach after surgery and was recently applied for EGC cases without possibility of lymph node metastasis. Function-preserving laparoscopic gastrectomy is recommended for the treatment of EGC if the indication followed by accurate diagnosis is strictly confirmed. Preservation of remnant stomach sometimes causes severe postoperative dysfunctions such as delayed gastric retention in PPG, esophageal reflux in PG, and gastric stump carcinoma in the remnant stomach. Moreover, these techniques present technical difficulties to the surgeon. Although many retrospective studies showed the functional benefit or oncological safety of function-preserving gastrectomy, further prospective studies using large case series are necessary.

References

  1. 1.
    Maehara Y, Kakeji Y, Oda S, Takahashi I, Akazawa K, Sugimachi K. Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer. Br J Cancer. 2000;83:986–91.PubMedCrossRefGoogle Scholar
  2. 2.
    Howes N, Chagla L, Thorpe M, McCulloch P. Surgical practice is evidence based. Br J Surg. 1997;84:1220–3.PubMedCrossRefGoogle Scholar
  3. 3.
    Songun I, Putter H, Kranenbarg EM, Sasako M, van de Velde CJ. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol. 2010;11:439–49.PubMedCrossRefGoogle Scholar
  4. 4.
    Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, et al. Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 2008;22:1729–35.PubMedCrossRefGoogle Scholar
  5. 5.
    Nishikawa K, Kawahara H, Yumiba T, Nishida T, Inoue Y, Ito T, et al. Functional characteristics of the pylorus in patients undergoing pylorus–preserving gastrectomy for early gastric cancer. Surgery. 2002;131:613–24.PubMedCrossRefGoogle Scholar
  6. 6.
    Maki T, Shiratori T, Hatafuku T, Sugawara K. Pylorus-preserving gastrectomy as an improved operation for gastric ulcer. Surgery. 1967;61:838–45.PubMedGoogle Scholar
  7. 7.
    Hiki N, Kaminishi M. Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches. Langenbecks Arch Surg. 2005;390:442–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Hiki N, Shimoyama S, Yamaguchi H, Kubota K, Kaminishi M. Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg. 2006;203:162–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Nunobe S, Hiki N, Fukunaga T, Tokunaga M, Ohyama S, Seto Y, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg. 2007;31:2335–40.PubMedCrossRefGoogle Scholar
  10. 10.
    Shibata C, Shiiba KI, Funayama Y, Ishii S, Fukushima K, Mizoi T, et al. Outcomes after pylorus-preserving gastrectomy for early gastric cancer: a prospective multicenter trial. World J Surg. 2004;28:857–61.PubMedCrossRefGoogle Scholar
  11. 11.
    Nunobe S, Sasako M, Saka M, Fukagawa T, Katai H, Sano T. Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer. 2007;10:167–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Hiki N, Sano T, Fukunaga T, Ohyama S, Tokunaga M, Yamaguchi T. Survival benefit of pylorus-preserving gastrectomy in early gastric cancer. J Am Coll Surg. 2009;209:297–301.PubMedCrossRefGoogle Scholar
  13. 13.
    Jiang X, Hiki N, Nunobe S, Fukunaga T, Kumagai K, Nohara K, et al. Long-term outcome and survival with laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Surg Endosc. 2011;25:1182–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Morita S, Katai H, Saka M, Fukagawa T, Sano T, Sasako M. Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg. 2008;95:1131–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13:238–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Sekine T, Sato T, Maki T, Shiratori T. Pylorus-preserving gastrectomy for gastric ulcer–one- to nine-year follow-up study. Surgery. 1975;77:92–9.PubMedGoogle Scholar
  17. 17.
    Tomita R, Fujisaki S, Tanjoh K. Pathophysiological studies on the relationship between postgastrectomy syndrome and gastric emptying function at 5 years after pylorus-preserving distal gastrectomy for early gastric cancer. World J Surg. 2003;27:725–33.PubMedCrossRefGoogle Scholar
  18. 18.
    Yamaguchi T, Ichikawa D, Kurioka H, Ikoma H, Koike H, Otsuji E, et al. Postoperative clinical evaluation following pylorus-preserving gastrectomy. Hepatogastroenterology. 2004;51:883–6.PubMedGoogle Scholar
  19. 19.
    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCrossRefGoogle Scholar
  20. 20.
    Sano T, Hollowood A. Early gastric cancer: diagnosis and less invasive treatments. Scand J Surg. 2006;95:249–55.PubMedGoogle Scholar
  21. 21.
    Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.PubMedCrossRefGoogle Scholar
  22. 22.
    Lee SW, Bouras G, Nomura E, Yoshinaka R, Tokuhara T, Nitta T, et al. Intracorporeal stapled anastomosis following laparoscopic segmental gastrectomy for gastric cancer: technical report and surgical outcomes. Surg Endosc. 2010;24:1774–80.PubMedCrossRefGoogle Scholar
  23. 23.
    Shimoyama S, Yasuda H, Mafune K, Kaminishi M. Indications of a minimized scope of lymphadenectomy for submucosal gastric cancer. Ann Surg Oncol. 2002;9:625–31.PubMedCrossRefGoogle Scholar
  24. 24.
    Shimoyama S, Mafune K, Kaminishi M. Indications for a pylorus-preserving gastrectomy for gastric cancer with proper muscle invasion. Arch Surg. 2003;138:1235–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Shimoyama S, Seto Y, Yasuda H, Mafune K, Kaminishi M. Concepts, rationale, and current outcomes of less invasive surgical strategies for early gastric cancer: data from a quarter-century of experience in a single institution. World J Surg. 2005;29:58–65.PubMedCrossRefGoogle Scholar
  26. 26.
    Isozaki H, Okajima K, Momura E, Ichinona T, Fujii K, Izumi N, et al. Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg. 1996;83:266–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Nakane Y, Akehira K, Inoue K, Iiyama H, Sato M, Masuya Y, et al. Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer. Hepatogastroenterology. 2000;47:590–5.PubMedGoogle Scholar
  28. 28.
    Imada T, Rino Y, Takahashi M, Suzuki M, Tanaka J, Shiozawa M, et al. Postoperative functional evaluation of pylorus-preserving gastrectomy for early gastric cancer compared with conventional distal gastrectomy. Surgery. 1998;123:165–70.PubMedCrossRefGoogle Scholar
  29. 29.
    Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 2nd English Edition. Gastric Cancer. 1998;1:10–24.PubMedCrossRefGoogle Scholar
  30. 30.
    Morii Y, Arita T, Shimoda K, Hagino Y, Yoshida, T, Kitano S. Indications for pylorus-preserving gastrectomy for gastric cancer based on lymph node metastasis. Hepatogastroenterology. 2002;49:1477–80.PubMedGoogle Scholar
  31. 31.
    Kodera Y, Yamamura Y, Kanemitsu Y, Shimizu Y, Hirai T, Yasui K, et al. Lymph node metastasis in cancer of the middle-third stomach: criteria for treatment with a pylorus-preserving gastrectomy. Surg Today. 2001;31:196–203.PubMedCrossRefGoogle Scholar
  32. 32.
    Nakajima T, Yamaguchi, T. Gastric Cancer Data Base in Cancer Institute, Japan; 1946–2004. 2006.Google Scholar
  33. 33.
    Sano T, Sasako M, Kinoshita T, Maruyama K. Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer. 1993;72:3174–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Sue-Ling HM, Johnston D, Martin IG, Dixon MF, Lansdown MR, McMahon MJ, et al. Gastric cancer: a curable disease in Britain. BMJ. 1993;307:591–6.PubMedCrossRefGoogle Scholar
  35. 35.
    Fujita T. Outcome of pylorus-preserving gastrectomy for early gastric cancer (Br J Surg 2008; 95: 1131–1135). Br J Surg. 2008;95:1429–30.PubMedCrossRefGoogle Scholar
  36. 36.
    Shinohara H, Sonoda T, Niki M, Nomura E, Nishiguchi K, Tanigawa N. Laparoscopically-assisted pylorus-preserving gastrectomy with preservation of the vagus nerve. Eur J Surg. 2002;168:55–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Sawai K, Takahashi T, Fujioka T, Minato H, Taniguchi H, Yamaguchi T. Pylorus-preserving gastrectomy with radical lymph node dissection based on anatomical variations of the infrapyloric artery. Am J Surg. 1995;170:285–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Hennessy TP, Weir DG, D’Auria D. Pylorus-preserving gastrectomy in the treatment of duodenal ulcer. Br J Surg. 1972;59:27–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Urushihara T, Sumimoto K, Shimokado K, Kuroda Y. Gastric motility after laparoscopically assisted distal gastrectomy, with or without preservation of the pylorus, for early gastric cancer, as assessed by digital dynamic X-ray imaging. Surg Endosc. 2004;18:964–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Michiura T, Nakane Y, Kanbara T, Nakai K, Inoue K, Yamamichi K, et al. Assessment of the preserved function of the remnant stomach in pylorus-preserving gastrectomy by gastric emptying scintigraphy. World J Surg. 2006;30:1277–83.PubMedCrossRefGoogle Scholar
  41. 41.
    Nakane Y, Michiura T, Inoue K, Sato M, Nakai K, Yamamichi K. Length of the antral segment in pylorus-preserving gastrectomy. Br J Surg. 2002;89:220–4.PubMedGoogle Scholar
  42. 42.
    Salvon-Harman JC, Cady B, Nikulasson S, Khettry U, Stone MD, Lavin P. Shifting proportions of gastric adenocarcinomas. Arch Surg. 1994;129:381–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Ekstrom AM, Signorello LB, Hansson LE, Bergstrom R, Lindgren A, Nyren O. Evaluating gastric cancer misclassification: a potential explanation for the rise in cardia cancer incidence. J Natl Cancer Inst. 1999;91:786–90.PubMedCrossRefGoogle Scholar
  44. 44.
    Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer. Surgery. 1998;123:127–30.PubMedCrossRefGoogle Scholar
  45. 45.
    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.PubMedCrossRefGoogle Scholar
  46. 46.
    Shiraishi N, Adachi Y, Kitano S, Kakisako K, Inomata M, Yasuda K. Clinical outcome of proximal versus total gastrectomy for proximal gastric cancer. World J Surg. 2002;26:1150–4.PubMedCrossRefGoogle Scholar
  47. 47.
    Furukawa H, Hiratsuka M, Imaoka S, Ishikawa O, Kabuto T, Sasaki Y, et al. Limited surgery for early gastric cancer in cardia. Ann Surg Oncol. 1998;5:338–41.PubMedCrossRefGoogle Scholar
  48. 48.
    Ichikawa D, Ueshima Y, Shirono K, Kan K, Shioaki Y, Lee CJ, et al. Esophagogastrostomy reconstruction after limited proximal gastrectomy. Hepatogastroenterology. 2001;48:1797–801.PubMedGoogle Scholar
  49. 49.
    Shiraishi N, Hirose R, Morimoto A, Kawano K, Adachi Y, Kitano S. Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy. Gastric Cancer. 1998;1:78–9.PubMedCrossRefGoogle Scholar
  50. 50.
    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.PubMedCrossRefGoogle Scholar
  51. 51.
    An JY, Youn HG, Choi MG, Noh JH, Sohn TS, Kim S. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg. 2008;196:587–91.PubMedCrossRefGoogle Scholar
  52. 52.
    Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, Ohyama S, et al. Laparoscopic esophagogastric circular stapled anastomosis: a modified technique to protect the esophagus. Gastric Cancer. 2007;10:181–6.PubMedCrossRefGoogle Scholar
  53. 53.
    Adachi Y, Inoue T, Hagino Y, Shiraishi N, Shimoda K, Kitano S. Surgical results of proximal gastrectomy for early-stage gastric cancer: jejunal interposition and gastric tube reconstruction. Gastric Cancer. 1999;2:40–5.PubMedCrossRefGoogle Scholar
  54. 54.
    Iwata T, Kurita N, Ikemoto T, Nishioka M, Andoh T, Shimada M. Evaluation of reconstruction after proximal gastrectomy: prospective comparative study of jejunal interposition and jejunal pouch interposition. Hepatogastroenterology. 2006;53:301–3.PubMedGoogle Scholar
  55. 55.
    Uyama I, Ogiwara H, Takahara T, Kikuchi K, Iida S. Laparoscopic and minilaparotomy proximal gastrectomy and esophagogastrostomy: technique and case report. Surg Laparosc Endosc. 1995;5:487–91.PubMedGoogle Scholar
  56. 56.
    Kameyama J, Ishida H, Yasaku Y, Suzuki A, Kuzu H, Tsukamoto M. Proximal gastrectomy reconstructed by interposition of a jejunal pouch. Surgical technique. Eur J Surg. 1993;159:491–3.PubMedGoogle Scholar
  57. 57.
    Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche JP, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111:85–92.PubMedCrossRefGoogle Scholar
  58. 58.
    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.PubMedCrossRefGoogle Scholar
  59. 59.
    Tomita R, Fujisaki S, Tanjoh K, Fukuzawa M. A novel operative technique on proximal gastrectomy reconstructed by interposition of a jejunal J pouch with preservation of the vagal nerve and lower esophageal sphincter. Hepatogastroenterology. 2001;48:1186–91.PubMedGoogle Scholar
  60. 60.
    Tokunaga M, Hiki N, Ohyama S, Nunobe S, Miki A, Fukunaga T, et al. Effects of reconstruction methods on a patient’s quality of life after a proximal gastrectomy: subjective symptoms evaluation using questionnaire survey. Langenbecks Arch Surg. 2009; 394:637–41.PubMedCrossRefGoogle Scholar
  61. 61.
    Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, et al. Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg. 2009;209:344–51.PubMedCrossRefGoogle Scholar
  62. 62.
    Takagawa R, Kunisaki C, Kimura J, Makino H, Kosaka T, Ono HA, et al. A pilot study comparing jejunal pouch and jejunal interposition reconstruction after proximal gastrectomy. Dig Surg. 2010;27:502–8.PubMedCrossRefGoogle Scholar
  63. 63.
    Stalsberg H, Taksdal S. Stomach cancer following gastric surgery for benign conditions. Lancet. 1971;2:1175–7.PubMedCrossRefGoogle Scholar
  64. 64.
    Toftgaard C. Gastric cancer after peptic ulcer surgery. A historic prospective cohort investigation. Ann Surg. 1989;210:159–64.PubMedCrossRefGoogle Scholar
  65. 65.
    Furukawa H, Iwanaga T, Hiratsuka M, Imaoka S, Ishikawa O, Kabuto T, et al. Gastric remnant cancer as a metachronous multiple lesion. Br J Surg. 1993;80:54–6.PubMedCrossRefGoogle Scholar
  66. 66.
    Langhans P, Heger RA, Hohenstein J, Schlake W, Bunte H. Operation-sequel carcinoma of the stomach. Experimental studies of surgical techniques with or without resection. World J Surg. 1981;5:595–605.PubMedCrossRefGoogle Scholar
  67. 67.
    Nishidoi H, Koga S, Kaibara N. Possible role of duodenogastric reflux on the development of remnant gastric carcinoma induced by N-methyl-N’-nitro-N-nitrosoguanidine in rats. J Natl Cancer Inst. 1984;72:1431–5.PubMedGoogle Scholar
  68. 68.
    Miwa K, Hasegawa H, Fujimura T, Matsumoto H, Miyata R, Kosaka T, et al. Duodenal reflux through the pylorus induces gastric adenocarcinoma in the rat. Carcinogenesis. 1992;13:2313–6.PubMedCrossRefGoogle Scholar
  69. 69.
    Greene FL. Management of gastric remnant carcinoma based on the results of a 15-year endoscopic screening program. Ann Surg. 1996;223:701–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Newman E, Brennan MF, Hochwald SN, Harrison LE, Karpeh MS, Jr. Gastric remnant carcinoma: just another proximal gastric cancer or a unique entity? Am J Surg. 1997;173:292–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Kaneko K, Kondo H, Saito D, Shirao K, Yamaguchi H, Yokota T, et al. Early gastric stump cancer following distal gastrectomy. Gut. 1998;43:342–4.PubMedCrossRefGoogle Scholar
  72. 72.
    Igami G, Isotani M, Harada T, Kaneoka Y, Akutagawa A, Sugawara G, et al. Remnant stomach cancer after proximal gastrectomy: a review of 26 cases in the Japanese literature. Jpn J Gastroenterol Surg. 2002;35:357–61.Google Scholar
  73. 73.
    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.PubMedCrossRefGoogle Scholar
  74. 74.
    Fisher SG, Davis F, Nelson R, Weber L, Goldberg J, Haenszel W. A cohort study of stomach cancer risk in men after gastric surgery for benign disease. J Natl Cancer Inst. 1993;85:1303–10.PubMedCrossRefGoogle Scholar
  75. 75.
    Lundegardh G, Adami HO, Helmick C, Zack M, Meirik O. Stomach cancer after partial gastrectomy for benign ulcer disease. N Engl J Med. 1988;319:195–200.PubMedCrossRefGoogle Scholar
  76. 76.
    Kondo K, Kojima H, Akiyama S, Ito K, Takagi H. Pathogenesis of adenocarcinoma induced by gastrojejunostomy in Wistar rats: role of duodenogastric reflux. Carcinogenesis. 1995;16:1747–51.PubMedCrossRefGoogle Scholar
  77. 77.
    Byrne JP, Attwood SE. Duodenogastric reflux and cancer. Hepatogastroenterology. 1999;46:74–85.PubMedGoogle Scholar
  78. 78.
    Bo T, Zhihong P, Peiwu Y, Feng Q, Ziqiang W, Yan S, et al. General complications following laparoscopic-assisted gastrectomy and analysis of techniques to manage them. Surg Endosc. 2009;23:1860–5.PubMedCrossRefGoogle Scholar
  79. 79.
    Mochiki E, Toyomasu Y, Ogata K, Andoh H, Ohno T, Aihara R, et al. Laparoscopically assisted total gastrectomy with lymph node dissection for upper and middle gastric cancer. Surg Endosc. 2008; 22:1997–2002.PubMedCrossRefGoogle Scholar
  80. 80.
    Jeong GA, Cho GS, Kim HH, Lee HJ, Ryu SW, Song KY. Laparoscopy-assisted total gastrectomy for gastric cancer: a multicenter retrospective analysis. Surgery. 2009;146:469–74.PubMedCrossRefGoogle Scholar
  81. 81.
    Lee SE, Ryu KW, Nam BH, Lee JH, Ki YW, Yu JS, et al. Technical feasibility and safety of laparoscopy-assisted total gastrectomy in gastric cancer: a comparative study with laparoscopy-assisted distal gastrectomy. J Surg Oncol. 2009;100:392–5.PubMedCrossRefGoogle Scholar
  82. 82.
    Jiang X, Hiki N, Nunobe S, Nohara K, Kumagai K, Sano T, et al. Laparoscopy-assisted subtotal gastrectomy with very small remnant stomach: a novel surgical procedure for selected early gastric cancer in the upper stomach. Gastric Cancer. 2011;14:194–9.PubMedCrossRefGoogle Scholar
  83. 83.
    Jentschura D, Winkler M, Strohmeier N, Rumstadt B, Hagmuller E. Quality-of-life after curative surgery for gastric cancer: a comparison between total gastrectomy and subtotal gastric resection. Hepatogastroenterology. 1997;44:1137–42.PubMedGoogle Scholar
  84. 84.
    Fujita T, Katai H, Morita S, Saka M, Fukagawa T, Sano T. Short-term outcomes of Roux-en-Y stapled anastomosis after distal gastrectomy for gastric adenocarcinoma. J Gastrointest Surg. 2010;14:289–94.PubMedCrossRefGoogle Scholar
  85. 85.
    Noshiro H, Ohuchida K, Kawamoto M, Ishikawa M, Uchiyama A, Shimizu S, et al. Intraabdominal Roux-en-Y reconstruction with a novel stapling technique after laparoscopic distal gastrectomy. Gastric Cancer. 2009;12:164–9.PubMedCrossRefGoogle Scholar
  86. 86.
    Kojima K, Yamada H, Inokuchi M, Kawano T, Sugihara K. A comparison of Roux-en-Y and Billroth-I reconstruction after laparoscopy-assisted distal gastrectomy. Ann Surg. 2008;247:962–7.PubMedCrossRefGoogle Scholar
  87. 87.
    Gonzalez R, Lin E, Venkatesh KR, Bowers SP, Smith CD. Gastrojejunostomy during laparoscopic gastric bypass: analysis of 3 techniques. Arch Surg. 2003;138:181–4.PubMedCrossRefGoogle Scholar
  88. 88.
    Omori T, Oyama T, Akamatsu H, Tori M, Ueshima S, Nakahara M, et al. A simple and safe method for gastrojejunostomy in laparoscopic distal gastrectomy using the hemidouble-stapling technique: efficient purse-string stapling technique. Dig Surg. 2009;26:441–5.PubMedCrossRefGoogle Scholar
  89. 89.
    Rembacken BJ, Gotoda T, Fujii T, Axon AT. Endoscopic mucosal resection. Endoscopy. 2001;33:709–18.PubMedCrossRefGoogle Scholar
  90. 90.
    Soetikno RM, Gotoda T, Nakanishi Y, Soehendra N. Endoscopic mucosal resection. Gastrointest Endosc. 2003;57:567–79.PubMedCrossRefGoogle Scholar
  91. 91.
    Nakajima T, Oda I, Gotoda T, Hamanaka H, Eguchi T, Yokoi C, et al. Metachronous gastric cancers after endoscopic resection: how effective is annual endoscopic surveillance? Gastric Cancer. 2006;9:93–8.PubMedCrossRefGoogle Scholar
  92. 92.
    Gotoda T, Yanagisawa A, Sasako M, Ono H, Nakanishi Y, Shimoda T, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer. 2000;3:219–25.PubMedCrossRefGoogle Scholar
  93. 93.
    Gotoda T, Oda I, Tamakawa K, Ueda H, Kobayashi T, Kakizoe T. Prospective clinical trial of magnetic-anchor-guided endoscopic submucosal dissection for large early gastric cancer (with videos). Gastrointest Endosc. 2009;69:10–5.PubMedCrossRefGoogle Scholar
  94. 94.
    Rosch T, Sarbia M, Schumacher B, Deinert K, Frimberger E, Toermer T, et al. Attempted endoscopic en bloc resection of mucosal and submucosal tumors using insulated-tip knives: a pilot series. Endoscopy. 2004;36:788–801.PubMedCrossRefGoogle Scholar
  95. 95.
    Ludwig K, Klautke G, Bernhard J, Weiner R. Minimally invasive and local treatment for mucosal early gastric cancer. Surg Endosc. 2005;19:1362–6.PubMedCrossRefGoogle Scholar
  96. 96.
    Ohgami M, Otani Y, Kumai K, Kubota T, Kim YI, Kitajima M. Curative laparoscopic surgery for early gastric cancer: five years experience. World J Surg. 1999;23:187–92.PubMedCrossRefGoogle Scholar
  97. 97.
    Hiki Y, Sakuramoto S, Katada N, Shimao H. Combined laparoscopic-endoscopic procedure in stomach carcinoma. Chirurg. 2000;71:1193–201.PubMedCrossRefGoogle Scholar
  98. 98.
    Kobayashi T, Kazui T, Kimura T. Surgical local resection for early gastric cancer. Surg Laparosc Endosc Percutan Tech. 2003;13:299–303.PubMedCrossRefGoogle Scholar
  99. 99.
    Asao T, Nakamura J, Shitara Y, Tsutsumi S, Mochiki E, Shimura T, et al. Loss of standard type of CD44 expression in invaded area as a good indicator of lymph-node metastasis in colorectal carcinoma. Dis Colon Rectum. 2000;43:1250–4.PubMedCrossRefGoogle Scholar
  100. 100.
    Nunobe S, Hiki N, Gotoda T, Murao T, Haruma K, Matsumoto H, et al. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer. Gastric Cancer. 2012;15:338–42.Google Scholar
  101. 101.
    Ikehara H, Gotoda T, Ono H, Oda I, Saito D. Gastric perforation during endoscopic resection for gastric carcinoma and the risk of peritoneal dissemination. Br J Surg. 2007;94:992–5.PubMedCrossRefGoogle Scholar
  102. 102.
    Inoue H, Ikeda H, Hosoya T, Yoshida A, Onimaru M, Suzuki M, et al. Endoscopic mucosal resection, endoscopic submucosal dissection, and beyond: full-layer resection for gastric cancer with nonexposure technique (CLEAN-NET). Surg Oncol Clin N Am. 2012;21:129–40.PubMedCrossRefGoogle Scholar
  103. 103.
    Goto O, Mitsui T, Fujishiro M, Wada I, Shimizu N, Seto Y, et al. New method of endoscopic full-thickness resection: a pilot study of non-exposed endoscopic wall-inversion surgery in an ex vivo porcine model. Gastric Cancer. 2011;14:183–7.PubMedCrossRefGoogle Scholar
  104. 104.
    Jiang X, Hiki N, Nunobe S, Fukunaga T, Kumagai K, Nohara K, et al. Postoperative outcomes and complications after laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Ann Surg. 2011;253:928–33.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Naoki Hiki
    • 1
  • Souya Nunobe
    • 1
  • Takeshi Kubota
    • 1
  • Xiaohua Jiang
    • 1
  1. 1.Department of Gastroenterological SurgeryCancer Institute Ariake HospitalTokyoJapan

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