Open AccessUniversalization of the operative strategy by systematic mesogastric excision for stomach cancer with that for total mesorectal excision and complete mesocolic excision colorectal counterparts
Author(s) -
Shinohara Hisashi,
Kurahashi Yasunori,
Haruta Shusuke,
Ishida Yoshinori,
Sasako Mitsuru
Publication year - 2018
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12048
Subject(s) - mesentery , total mesorectal excision , medicine , colorectal cancer , surgery , cancer , general surgery
Gastrointestinal cancer surgery aims at en bloc removal of the primary tumor with its lymphatic drainage by excising organ‐specific mesentery as an “intact package”. This concept was advocated in colorectal cancer surgery as total mesorectal excision ( TME ) or complete mesocolic excision ( CME ) procedures, but is not directly applicable to stomach cancer as a result of the morphological complexities of the gastric mesentery. In this review, we discuss the unique anatomical features of the mesogastrium by introducing its embryology, disclose its similarity to the mesosigmoid, and then propose a theoretical concept to mesentery‐based D2 gastrectomy, namely systematic mesogastric excision, which can universalize the operative strategy of stomach cancer with that of TME and CME colorectal counterparts.