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Laparoscopic proximal gastrectomy for gastric neoplasms
Author(s) -
Kukar Moshim,
Gabriel Emmanuel,
BenDavid Kfir,
Hochwald Steven N.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25123
Subject(s) - medicine , gastrectomy , dissection (medical) , perioperative , surgery , anastomosis , stage (stratigraphy) , cancer , lymph node , stomach , cohort , general surgery , paleontology , biology
Background For cancers of the distal gastroesophageal junction or the proximal stomach, proximal gastrectomy can be performed. It is associated with several perioperative benefits compared with total gastrectomy. The use of laparoscopic proximal gastrectomy (LPG) has become an increasingly popular approach for select tumors. Methods We describe our method of LPG, including the preoperative work‐up, illustrated depictions of the key steps of the surgery, and our postoperative pathway. Results A total of 6 patients underwent LPG between July, 2013 to June, 2017. Five patients had early‐stage adenocarcinoma, and 1 patient had a gastrointestinal stromal tumor. The median age of the cohort was 70, and each patient had significant comorbidities. Conversion to open was required for 1 patient. All patients had negative final margins and an adequate lymph node dissection (median number of nodes examined was 15, range 12‐22). The median postoperative length of stay was 7 days (range 4‐7). Two patients developed anastomotic strictures requiring intervention, and 1 patient experienced significant reflux. At a median follow‐up of 11 months, there was 1 recurrence. Three patients were alive without evidence of disease, and 2 patients died from other causes. Conclusions For carefully selected patients, LPG is a safe and reasonable alternative to total gastrectomy, which is associated with similar oncologic outcomes and low morbidity.