Changing Trends in Gastric Cancer Surgery
Journal Title: Balkan Medical Journal - Year 2017, Vol 34, Issue 1
Abstract
Gastric cancer is one of the most common causes of cancer-related death. It requires multimodal treatment and surgery is the most effective treatment modality. Radical surgery includes total or subtotal gastrectomy with lymph node dissection. The extent of lymphadenectomy still remains controversial. Eastern surgeons have performed D2 or more extended lymphadenectomy while their Western colleagues have performed more limited lymph node dissection. However, the trend has been changing in favour of D2 lymph node dissection in both hemispheres. Currently, D2 is the recommended type of lymphadenectomy in experienced centres in the west. In Japan, D2 lymph node dissection is the standard surgical approach. More extensive lymphadenectomy than D2 has not been found to be associated with improved survival and generally is not performed. Bursectomy and splenectomy are additional controversial issues in surgical performance, and trends regarding them will be discussed. The performance of bursectomy is controversial and there is no clear evidence of its clinical benefit. However, a trend toward better survival in patients with serosal invasion has been reported. Routine splenectomy as a part of lymph node dissection has largely been abandoned, although splenectomy is recommended in selected cases. Minimally invasive surgery has gained wide popularity and indications for minimally invasive procedures have been expanding due to increasing experience and improving technology. Neoadjuvant therapy has been shown to have beneficial effects and seems necessary to provide a survival benefit. Diagnostic laparoscopy should be kept in mind prior to treatment.
Authors and Affiliations
İlter Özer, Erdal Birol Bostancı, Murat Ulaş, Yusuf Özoğul, Musa Akoğlu
Keywords
Related Articles
- EP ID EP380219
- DOI 10.4274/balkanmedj.2015.1461
- Views 88
- Downloads 0
Undergraduate Internal Medicine Training and Medical University Curriculum in Romania
.
Unilateral Type of Macrodystrophia Lipomatosa of the Thumb, Index Finger, and Thenar
.
A Rare Cause of Reversible Splenial Lesion Syndrome: A Case Report with Epilepsy
.
Central Auditory Processing Disorders in Individuals with Autism Spectrum Disorders
The etiology and the underlying pathogenetic mechanisms of autism spectrum disorders are still largely unknown. This article provides a comprehensive review of the studies that are relevant to autism spectrum disorders a...
The Use of Human Epididymis 4 and Cancer Antigen 125 Tumor Markers in the Benign or Malignant Differential Diagnosis of Pelvic or Adnexal Masses
Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumo...