Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma

Sano, Takeshi; Sasako, Mitsuru; Mizusawa, Junki; Yamamoto, Seiichiro; Katai, Hitoshi; Yoshikawa, Takaki; Nashimoto, Atsushi; Ito, Seiji; Kaji, Masahide; Imamura, Hiroshi; Fukushima, Noriyoshi; Fujitani, Kazumasa

doi:10.1097/sla.0000000000001814

Cited by 272 publications

(254 citation statements)

References 22 publications

Supporting

Mentioning

240

Contrasting

Unclassified

Order By: Relevance

“…The results of the JCOG0110 trial, which examined the importance of splenectomy in advanced primary gastric cancer, showed that splenectomy could be omitted if the lesion was not a greater curvature lesion [24]. We examined the influence of circumferential location of the tumor (Table S1 in the Electronic supplementary material, ESM).…”

Section: Discussionmentioning

confidence: 99%

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach

et al. 2016

View full text Add to dashboard Cite

Purpose In cases of carcinoma in the remnant stomach (CRS), the lymphatic flow may be altered by the initial surgery. In this study of CRS after gastrectomy, we investigated how the regions of lymph node metastasis and changes in lymphatic flow depend on initial disease status. Method The study included 76 patients with CRS who underwent gastrectomy between September 2002 and November 2014. We analyzed and compared the clinicopathological factors and survival periods between patients after distal gastrectomy for malignant disease (group M, 33 patients) and patients after distal gastrectomy for benign disease (group B, 43 patients).Results The depth of tumor invasion was more advanced in group B (T1/T2/T3/T4: group M 18/1/7/7, group B 8/11/ 8/16; P = 0.002). However, the degree of lymph node metastasis did not differ significantly between the two groups. The incidence of lymph node metastasis was high at stations 2 (19 %), 4sa (17 %), 10 (25 %), 11p (19 %), and 11d (27 %) in group M and 1 (14 %), 3 (23 %), and 4sb (15 %), and the mesojejunal lymph node (21 %) in group B. Lymph node dissection was highly beneficial at station 3, station 7, and the mesojejunum in both groups, but not at stations 10 or 11d.Conclusion As compared with group B, group M showed higher incidences of lymph node metastasis in the greater curvature, splenic hilum, and lymph nodes along the splenic artery, suggesting the predominance of lymphatic flows from the greater curvature to the splenic hilum and from the remnant stomach to the splenic artery.

show abstract

Section: Discussionmentioning

confidence: 99%

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach

et al. 2016

View full text Add to dashboard Cite

show abstract

“…was able to demonstrate the feasibility of carrying out para‐aortic dissection on top of D2 lymphadenectomy for gastric cancer, although there was no benefit to the 5‐year overall survival 24, 25. Most recently, Sano et al 26. showed that splenectomy for patients with proximal gastric cancer that does not involve the greater curvature was associated with increased morbidity without improving the overall 5‐year survival.…”

Section: Gastric Surgerymentioning

confidence: 99%

Gastroenterological surgery in Japan: The past, the present and the future

Colvin

Mizushima

Eguchi

et al. 2017

Annals of Gastroent Surgery

138

View full text Add to dashboard Cite

In the last two centuries, there has been remarkable progress in the field of gastroenterological surgery, including the curative resection of cancers, replacement of failed organs through transplantation, increased safety of undergoing major surgeries and decreased operative morbidity through developments in minimal access surgery. Japan has very much been at the forefront of these advances, as is evident from the present review, from advancing the surgical management of gastric cancer to the pioneering work in live‐donor transplantation. This review also highlights many instances where surgical management of the same pathologies has evolved differently between Japan and the West. It is encouraging that many procedures established in Japan are eventually taken up by the West, often after rigorous assessment affirming the quality and applicability of such techniques. In Japan, many of the crucial issues in gastroenterological surgery are increasingly addressed through large multi‐institutional prospective control trials, ensuring that Japanese surgeons continue to contribute to the advances in gastroenterological surgery.

show abstract

“…Long-term outcomes of this study have shown no survival benefit of splenectomy, but resulted in enhancing morbidity rate (15). Previous articles reported that morbidity rate of total gastrectomy with splenectomy, either by open surgery or LS, as 9.6-33.3% (16,17).…”

Section: Indications Of the Splenic Hilar Dissectionmentioning

confidence: 87%

Three-dimensional computed tomography simulation for laparoscopic lymph node dissection in the treatment of proximal gastric cancer

Sunagawa¹,

Kinoshita²

2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

Application of laparoscopic surgery (LS) has expanded worldwide in the various fields due to the potential advantage of being less invasive than open surgery; however difficulty in recognizing positional relationship of the organs is one of the disadvantages of this kind of surgery. In order to compensate this drawback, preoperative three-dimensional computed tomography (3D-CT) simulation is regarded as promising. In gastric cancer surgery, 3D-CT simulation seems particularly effective in the splenic hilar dissection, because this region is associated with remarkable anatomical variation with complexity. As effects from the use of 3D-CT simulation, reduction of blood loss or complication rate, shortening of operation time and enhancement of surgical quality are expected. In this article, we introduce our methodological protocol of 3D-CT simulation in gastric cancer surgery with clinical case examples, and also additionally review previous publications reporting this imaging technology.

show abstract

Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma

Abstract: In total gastrectomy for proximal gastric cancer that does not invade the greater curvature, splenectomy should be avoided as it increases operative morbidity without improving survival.

Cited by 272 publications

References 22 publications

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach

Effects of initial disease status on lymph flow following gastrectomy in cases of carcinoma in the remnant stomach

Gastroenterological surgery in Japan: The past, the present and the future

Three-dimensional computed tomography simulation for laparoscopic lymph node dissection in the treatment of proximal gastric cancer

Contact Info

Product

Resources

About