A Study on Carcinoma of the Gastric Stump with Special Reference to Lymph Node Dissection in the Mesojejunum.

Kosaka, Takeo; Ueshige, Nobuo; Sugaya, J; Nakano, Yujiro; Akiyama, Takayoshi; Takeuchi, Fujio; Saitô, Hitoshi; Kita, Ichiro; Takashima, Shigeki

doi:10.5833/jjgs.32.972

Cited by 4 publications

(4 citation statements)

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“…However, most surgeons today accept that extended lymphadenectomy may improve the prognosis in a subgroup of patients with GSC who have a limited number of positive LNs [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Current studies reveal that GSC has the following main lymphatic inflow pathway: (1) pathway A, lymphatic drainage along the left gastric artery, posterior gastric artery, and splenic artery; (2) pathway B, along anastomostic duodenum and jejunum and their mesentery; and (3) pathway C, mediastinal lymphatic drainage [4,7,10,12] (Fig. 2).…”

Section: Rule Of Lymphatic Flow and The Extent For Ln Dissection For Gscmentioning

confidence: 99%

“…Lymph drainage from the greater curvature and splenic hilus would therefore seem to be of greater importance than that from the lesser curvature and hepato-duodenal ligament, and this is probably related to previous resection of the lymph channels along the left gastric vessels. Therefore, some surgeons [6,7,10,11] suggested that a total gastrectomy with splenectomy for GSC would be required in order to achieve effective LN clearance. Dissection of the splenic artery nodes (No.…”

Section: Surgical Policy For Gscmentioning

confidence: 99%

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Metastatic pattern of lymph node and surgery for gastric stump cancer

Han

Hua

Wang

et al. 2003

Journal of Surgical Oncology

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Our results imply that GSC has a wide range of LN metastases, including LN within jejunal mesentery in B-II reconstruction cases, and curable resection may obtain better results. Therefore, we suggest that radical operation for B-I patients needs removal of gastroduodenectomy anastomosis and the above LNs, and that B-II patients need removal of 10 cm of jejunum besides gastrojejunostomy anastomosis, and clearance of LN within its mesentery, in addition to B-I GSC.

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“…However, most surgeons today accept that extended lymphadenectomy may improve the prognosis in a subgroup of patients with GSC who have a limited number of positive LNs [10,11].…”

Section: Discussionmentioning

confidence: 99%

Section: Rule Of Lymphatic Flow and The Extent For Ln Dissection For Gscmentioning

confidence: 99%

Section: Surgical Policy For Gscmentioning

confidence: 99%

See 1 more Smart Citation

Metastatic pattern of lymph node and surgery for gastric stump cancer

Han

Hua

Wang

et al. 2003

Journal of Surgical Oncology

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“…In an advanced remnant stomach cancer, adequate resection of the jejunum and lymph nodes, especially lymph node dissection around the SMA, is important [ 7 , 11 ]. Some patients with a remnant stomach cancer showed a long survival after optimal lymph node dissection [ 5 , 12 , 13 ]. Also in an esophageal cancer after total gastrectomy, the mesojejunal lymph nodes may be regional lymph nodes, and therefore resection of the interposed jejunum used for reconstruction with mesojejunectomy will be required.…”

Section: Discussionmentioning

confidence: 99%

A case of esophageal cancer with mesojejunal lymph node metastasis after total gastrectomy

et al. 2011

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A 56-year-old man was diagnosed with esophageal cancer by upper gastrointestinal endoscopy for examination of dysphagia. The patient had undergone total gastrectomy and jejunal interposition 4 years previously for a gastric cancer at the pT1N0M0 stage according to the UICC-TNM classification. Enhanced CT findings revealed a 3-cm-diameter mass located near the superior mesenteric artery. We conducted subtotal esophagectomy associated with partial jejunectomy including mesojejunectomy. The mass was histologically diagnosed to be mesojejunal lymph node metastasis from esophageal cancer. Mesojejunal lymph node metastasis from esophageal cancer developing after total gastrectomy has been reported in only three cases including ours. The present lymph node metastases may have occurred via the newly developed lymphatic drainage route through the esophagojejunostomy, and this metastatic lymph node can be considered the regional lymph node. Therefore, resection of the interposed jejunal limb with mesojejunectomy may be rational in surgery on esophageal cancer developing after total gastrectomy.

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Subtotal Gastrectomy with Limited Lymph Node Dissection is a Feasible Treatment Option for Patients with Early Gastric Stump Cancer

Irino

Hiki

Nunobe

et al. 2014

Journal of Gastrointestinal Surgery

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The de facto standard treatment for early gastric stump cancer (GSC) has been total gastrectomy combined with radical lymph node dissection. However, some patients could benefit if partial resection of the gastric stump is feasible. We investigated the feasibility of subtotal gastrectomy for early GSC as less invasive surgery. Subtotal gastrectomy was defined as a segmental resection of the gastric remnant including the anastomosis with limited lymph node dissection. A total of 66 patients with early GSC were enrolled and 24 patients (36.4 %) underwent subtotal gastrectomy (SG group). Clinicopathological characteristics were analyzed along with those of the other 42 patients (63.6 %) who underwent total gastrectomy (TG group). There were no significant differences between the two groups in the number of lymph nodes harvested (p = 0.880). Lymph node involvement was detected in 2 patients (8.3 %) in SG group and 5 patients (11.9 %) in TG group (p = 1.000). The previous disease (benign or malignant) and surgery (Billroth I or II) did not affect the rate of nodal involvement. The 5-year overall survival rate of SG group (94.7 %) was acceptable. Subtotal gastrectomy of the gastric remnant could be a feasible treatment option for patients with early gastric stump cancer when indicated.

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A Study on Carcinoma of the Gastric Stump with Special Reference to Lymph Node Dissection in the Mesojejunum.

Cited by 4 publications

References 0 publications

Metastatic pattern of lymph node and surgery for gastric stump cancer

Metastatic pattern of lymph node and surgery for gastric stump cancer

A case of esophageal cancer with mesojejunal lymph node metastasis after total gastrectomy

Subtotal Gastrectomy with Limited Lymph Node Dissection is a Feasible Treatment Option for Patients with Early Gastric Stump Cancer

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