Minimally Invasive Treatment of Stomach Cancer : The Cancer Journal (original) (raw)

MINIMALLY INVASIVE TREATMENT OF CANCER

Otsuka, Koji MDa; Murakami, Masahiko PhDa; Aoki, Takeshi PhDa; Tajima, Yusuke PhDa; Kaetsu, Tsutomu PhDa; Lefor, Alan T. MD, MPH, FACSb

aDepartment of Surgery, Division of General & Gastroenterological Surgery, Showa University School of Medicine, 1–5–8, Hatanodai, Shinagawa-ku, Tokyo 142–8666, Japan

bDepartment of Surgery, Cedars-Sinai Medical Center Los Angeles, California, and the Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California and the Center for Graduate Medical Education, Jichi Medical School, Tochigi, Japan.

Reprint requests: Alan T. Lefor, MD, MPH, Director, Division of Surgical Oncology, Department of Surgery, Cedars-Sinai Department of Surgery, 8700 Beverly Boulevard, Suite 8215, Los Angeles, CA 90048. E-mail: [email protected].

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.

Received on October 25, 2004; accepted for publication November 8, 2004.

Abstract

The rate of detection of early gastric cancer has increased because of the development of diagnostic techniques, such as endoscopy, biopsy, and endoscopic ultrasonography. Recently, minimally invasive surgical procedures for benign gastric conditions have been advocated, and the laparo-scopic approach is noted as a technique that increases the quality of life. However, the development of laparoscopic gastric resections and laparoscopically assisted gastric operations for malignancy still deserve a word of caution. Laparoscopic local resection of the stomach is used to treat mucosal cancer without lymph node metastasis, and laparoscopy-assisted distal gastrectomy is used to treat early gastric cancer with lymph node metastasis in the perigastric portion. According to short-term results reported by a small group of surgeons, laparoscopic approaches for gastric cancer result in a minimally invasive approach, early recovery, and decreased morbidity and mortality. However, the long-term results of these less invasive treatments are not known in advanced gastric cancer. If the results of randomized controlled studies for advanced gastric cancer are confirmed, the use of these techniques will spread worldwide and may become a standard technique for the resection of gastric cancer.