The lymphatic spread of gastric cancer

Sunderland, Douglas A.; McNeer, Gordon; Ortega, Loijis G.; Pearce, Leroy S.

doi:10.1002/1097-0142(195309)6:5<987::aid-cncr2820060518>3.0.co;2-3

Cited by 55 publications

(9 citation statements)

References 4 publications

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“…The operation is based on knowledge of the regional lymphatic drainage of the stomach. In accordance with the basic tenets of oncologic resection for epithelial cancers, surgical treatment requires wide excision of the primary gastric tumor and en bloc removal of the draining lymphatic network, including the regional lymph nodes and the intervening lymphatic vessels [13,14]. D2 gastric resections are followed by higher morbidity and mortality rates than D1 resections [3,4].…”

Section: Discussionmentioning

confidence: 99%

Ultrasonically Activated Shears in Extended Lymphadenectomyfor Gastric Cancer

et al. 2002

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Gastrectomy, followed by extended lymphadenectomy, is the treatment of choice in some stages of advanced gastric cancer. Lymphorrhea, as a result of the many divided lymphatic vessels, increases the morbidity. Ultrasonically activated coagulated shears (UACS) may divide all small vessels followed by immediate sealing of the coapted vessel walls. We designed a prospective randomized study to determine the effectiveness of the UACS versus monopolar electrosurgery in D2 dissection. Forty patients with gastric cancer stage II or stage IIIA were enrolled and randomized into 2 groups of 20 patients each. Group A underwent lymphatic dissection with monopolar cautery. Group B underwent lymphatic dissection with UACS. Subhepatic and left sudiaphragmatic closed drains were left until lymphorrhea and/or oozing stopped. Total gastrectomy was performed in 16 patients of group A and 14 of group B; subtotal gastrectomy was performed in 4 patients in group A and 6 patients in group B. The drains were removed after 6-17 days (mean 9.7 +/- 2.9) in group Aand after 4-8 days (mean 5.6 +/- 1.2) in group B(p < 0.001). The total amount of drained fluid was 300-2050 ml (mean 985 +/- 602) in group A and 230-1080 ml (mean 480 +/- 242) in group B (p < 0.002). Eight patients in group A and 5 in group B had postoperative fever, while 3 and 1 patients, respectively, had wound infections. In conclusion the use of UACS is a safe method of lymphatic dissection which reduces operative blood loss, postoperative lymphorrhea, blood transfusions,and hospital stay.

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Section: Discussionmentioning

confidence: 99%

Ultrasonically Activated Shears in Extended Lymphadenectomyfor Gastric Cancer

et al. 2002

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“…Los resultados favorables que presenta la Escuela Japonesa (23,24), están relacionados directamente a los exámenes masivos de detección que se realizan en este país y que permiten el diagnóstico temprano del cáncer gástrico hasta en un 60%. Esta experiencia única no ha podido ser imitada por ningún otro país del mundo porque demanda un alto costo que los países no pueden afrontar.…”

Section: Tratamiento Quirurgicounclassified

Cáncer de estómago.

Besada¹

2013

Rev Med Hered

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“…Subsequently, techniques for curative gastrectomy with radical lymphadenectomy were standardized at Memorial Sloan-Kettering in the early 1950s. 18,19 Several Japanese groups have improved our understanding of the complex patterns of gastric lymphatic drainage patterns with detailed pathologic analyses and activated carbon particle mapping. 20,21 Conservative lymphadenectomy (CLND), or D1 dissection, involves resection of only the perigastric nodes along the lesser and greater curvatures.…”

Section: Extent Of Lymph Node Dissectionmentioning

confidence: 99%

Controversies in the Surgical Management of Gastric Cancer

Kooby

Coit

2003

J Natl Compr Canc Netw

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Although the incidence of gastric adenocarcinoma in the United States has declined steadily since the early 1900s, it remains a significant health problem. Progress has been made during the past few decades in several areas: Lymph node staging has been refined, perioperative mortality has fallen, and plausible adjuvant therapy has emerged. Currently, complete surgical resection is the mainstay of therapy because it is the only potentially curative option; however, considerable controversy remains regarding the specifics of a surgical approach. This article examines 4 major controversies in the management of gastric cancer: extent of gastric resection, role of extended lymph node dissection, value of elective splenectomy for proximal gastric lesions, and current state of adjuvant therapy. Pertinent retrospective and prospective studies are reviewed to help formulate meaningful conclusions.

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The lymphatic spread of gastric cancer

Cited by 55 publications

References 4 publications

Ultrasonically Activated Shears in Extended Lymphadenectomyfor Gastric Cancer

Ultrasonically Activated Shears in Extended Lymphadenectomyfor Gastric Cancer

Cáncer de estómago.

Controversies in the Surgical Management of Gastric Cancer

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