Surgery for Gastric Cancer 9783662455821, 9783662455838, 2018968148
2,147 96 13MB
English Pages [355] Year 2019
Table of contents :
Contents
Part I: History of Gastric Cancer Surgery
1: History of Gastric Cancer Surgery
Progress of Supportive Background for Gastric Cancer Surgery
Anesthesia
Aseptic Method
Antibacterial Agents
Intravenous Infusion Therapy
Suture Materials and Surgical Instruments
Advancement in Pathological Knowledge
Progress of Diagnostic Methods
Challengers of Gastric Resection
Powerful Drive for Curability
Total Gastrectomy
Combined Resection of the Neighboring Organs
Lymph Node Dissection
Surgery for Peritoneal Metastasis
New Trends: From Standardized Surgery to Individual Surgery
Function-Preserving Surgery
Optimal Extent of Lymph Node Dissection
Minimally Invasive Surgery
National and International Study Groups for Gastric Cancer
Last Comment
References
Part II: Staging of Gastric Cancer
2: Staging of Gastric Cancer: Current Revision and Future Proposal
Revisions on the Current Edition TNM Classification for Gastric Cancer
Explicit Staging in Esophagogastric Junction Carcinoma
Proposal of Positive Cytology as Distant Metastasis
Minimum Number of Examined Lymph Nodes
Proposed Lymph Node Ratio to Be Included in the Staging System
Prefix “y” for TNM Classification After Neoadjuvantly Treated Tumor
Proposal of the Next Edition TNM Classification for Gastric Cancer
Amendment Both Extent and Number of Dissected Lymph Nodes as the Prerequisites for Staging the Lymph Node Metastasis
Occult Tumor Cells in Lymph Nodes as a Novel Subcategory of N Stage
Extracapsular Lymph Node Involvement in Gastric Cancer
Other Variables’ Assessment for Enhancement of the Efficiency of Stage of Gastric Cancer
References
Part III: Diagnosis of Gastric Cancer
3: Endoscopic Diagnosis: Esophagogastroduodenoscopy (EGD) and Endoscopic Ultrasound (EUS)
EGD
Early Gastric Cancer (EGC)
Tips for Early Detection of Gastric Cancer
Advanced Gastric Cancer (AGC)
EUS
References
4: Radiologic Diagnosis (CT, MRI, & PET-CT)
CT
Introduction
Tumor Staging
T Staging
N Staging
M Staging
Preoperative Evaluation of Perigastric Vascular Anatomy
Differential Diagnosis
Mucinous Adenocarcinoma
Lymphoma
Helicobacter Gastritis
MR Imaging
PET-CT
Introduction
Diagnosis and TNM Staging with FDG PET/CT
Diagnosis
Lymph Node Staging
Metastasis
References
Part IV: Treatment of Gastric Cancer
5: Endoscopic Treatment for Early Gastric Cancer
Introduction
History of Endoscopic Resection
Treatment Strategy for Endoscopic Resection
Principle
Indication Criteria
Pathological Staging
Clinical Management After Endoscopic Resection
References
Part V: Open Surgery for Gastric Cancer
6: Open Surgery for Gastric Cancer: Distal Subtotal Gastrectomy with D2 Lymph Node Dissection
Introduction
D2 Lymph Node Dissection
Oncologic Principles for Gastric Cancer Surgery
Omentectomy and Bursectomy
Surgical Procedure for Distal Subtotal Gastrectomy with D2 Lymph Node Dissection
Indication
Contraindication
Preoperative preparation
Anesthesia
Position of Patient During Surgery
Incision, Exposure, and Preparation of Main Procedures
Details of Procedure for D2 Lymph Node Dissection
Total Omentectomy and Bursectomy
Dissection of Lymph Node #6
Dissection of Lymph Nodes #4d and #4sb
Dissection of Lymph Node #5 and Duodenal Transection
Suprapancreatic Lymph Node Dissection (#12a, #8a, #7, #11p, and #9)
Dissection of Lymph Nodes #1 and #3
Gastric Resection to Achieve a Tumor-Free Proximal Margin
Checking the Status of Lymph Nodes According to Their Anatomical Location
Discussion
References
7: Open Surgery for Gastric Cancer: Total Gastrectomy with D2 Lymph Node Dissection
Introduction
Beginning of TG
Extent of Lymph Node Dissection of TG for Gastric Cancer
Era of Combined Resection Moved to Organ Preservation for TG
Surgical Procedure for Total Gastrectomy with D2 Lymph Node Dissection
Dissection of Lymph Nodes #11d
Dissection of Lymph Nodes #4sa, #10, and #2
References
8: Gastrectomy with D3 Lymph Node Dissection
Indication
Prophylactic Nodal Dissection
Therapeutic Dissection
Technique
References
9: Open Surgery for Gastric Cancer: Reconstruction
Introduction
Operative Technique
Reconstruction After Distal Gastrectomy
Gastroduodenostomy (Billroth I Reconstruction)
Surgical Technique
Gastrojejunostomy (Billroth II Reconstruction)
Surgical Technique
Roux-en-Y Gastrojejunostomy
Surgical Technique
Reconstruction After Total Gastrectomy
Roux-en-Y Esophagojejunostomy
Surgical Technique
Summary
References
Part VI: Laparoscopic Surgery for Gastric Cancer
10: Laparoscopic Surgery for Gastric Cancer: Distal Subtotal Gastrectomy with D2 Lymph Node Dissection
Introduction
Setup
List of Instruments
Patients
OR Setup
Patient’s Position
Trocar Arrangement (Fig. 10.3)
D2 Lymph Node Dissection
Outermost Layer-Oriented Medial Approach
Details of D2 Dissection in Distal Gastrectomy
#4d Dissection
#4sb Dissection
#6 Dissection
Transection of the Duodenum
Lesser Omentum, Top of #1
Rolling Up the Stomach
Probing the Outermost Layer of CHA and SPA
#5 Dissection
Medial Approach [1, 11]
#12a Dissection
#9(R) Dissection
#7 Dissection
#11p Dissection
#9(L) Dissection
#1 and 3 Dissection
Transection of the Stomach
Results
Discussion
Conclusions
References
11: Laparoscopic Surgery for Gastric Cancer, Total Gastrectomy with D2 Lymph Node Dissection
Introduction
Setup
Indications for Laparoscopic Total Gastrectomy with D2 Lymph Node Dissection
OR Setup
Patient’s Position
Port Placement
Liver Retraction
Details of D2 Dissection in Total Gastrectomy
Omentectomy
#4sb Dissection #4sa Dissection
#11d and #10 Dissection
#2 Dissection
#4d and #6 Dissection and Duodenal Transection
Suprapancreatic Dissection (#5, #12a, #8, #7, #9, #1, and #11p)
Distal Esophagus Transection
Reconstruction and Specimen Retrieval
Splenectomy for #10 Dissection
References
12: Intracorporeal Reconstruction in Laparoscopic Gastrectomy
Introduction
Materials and Methods
Patients
Operative Technique
Reconstruction in LDG
Reconstruction in LTG
Results
Discussion
Conclusions
References
Part VII: Robotic Surgery for Gastric Cancer
13: Distal Subtotal Gastrectomy with D2 Lymph Node Dissection
Introduction
Advantages of Robotic Gastrectomy and Clinical Assessment of Its Application
Overview
Specific Advantages in Robotic Gastrectomy with D2 Lymphadenectomy
Clinical Assessment of Robotic Gastrectomy
Indication
Operative Procedures [7, 25, 26]
Operating Room Setup
Patient Positioning and Port Placement
Docking
Instrumentations
Liver Retraction
Left-Side Dissection and Greater Curvature Mobilization (Lymph Node #4sb and #4d Dissection)
Right-Side Dissection and Infrapyloric Area Dissection (Lymph Node #6 and #14v Dissection)
Supraduodenal Dissection and Duodenal Transection
Suprapancreatic Area Dissection (Lymph Node #5, #7, #8a, #9, #11p, and #12a Dissection)
Lesser Curvature Dissection (Lymph Node #1 and #3 Dissection)
Gastric Resection, Anastomosis, and Specimen Retrieval
Limitation and Future Perspectives
Conclusion
References
14: Total Gastrectomy with D2 Lymph Node Dissection
Introduction
Indications for Robotic TG with D2 Lymph Node Dissection
Robot Setup and Patient Positioning
Surgical Technique
Splenic Hilar Dissection
Dissection of the Left Side Gastropancreatic Fold
Dissection of the Right Side Gastropancreatic Fold
Reconstruction
Discussion
References
15: Reconstruction Methods After Robotic Distal or Total Gastrectomy
Introduction
Operative Setting and Preparation for Reconstructions
Intracorporeal Billroth I Reconstruction after Robotic Distal Gastrectomy
Surgical Techniques for Linear-Shaped Gastroduodenostomy
Intracorporeal Roux-en-Y Esophagojejunostomy After Robotic Total Gastrectomy
Surgical Techniques for the Modified Overlap Method Using Barbed Sutures (MOBS)
Conclusions
References
Part VIII: Function-Preserving Surgery
16: Pylorous-Preserving Gastrectomy
Introduction
Indication
Surgical Techniques (Figs. 16.1, 16.2, 16.3, and 16.4 and Video)
Oncologic Safety
Advantages and Pitfalls
KLASS-04 Study: A Multicenter Prospective Randomized Controlled Trial
References
17: Surgery for Gastric Cancer: Proximal Gastrectomy
Introduction
Extent of Resection and Lymphadenectomy
Reconstruction Methods and Complications
Functional Benefits
Oncologic Safety
Conclusion
References
18: Vagus-Preserving Gastrectomy
Introduction
Surgical Anatomy
Hepatic Branch
Celiac Branch
Hepatic Nerve Plexus
Operational Procedure
Short-Term Results
Long-Term Results
Conclusion
References
Part IX: Sentinel Node Navigation Surgery
19: Sentinel Node Navigation Surgery
Introduction
Laparoscopic SN Mapping Procedures for Gastric Cancer
Results of SN Mapping in Gastric Cancer
Clinical Application of Laparoscopic SN Navigation Surgery in Early Gastric Cancer
Non-exposed Endoscopic Wall-Inversion Surgery Plus SN Mapping
Conclusion
References
Part X: Surgery for EG Junction Cancer
20: Surgery for EG Junction Cancer
Gastric Cancer or Esophageal Cancer or Else?
Surgical Procedures
Lymphadenectomy
Our Surgical Procedure
References
Part XI: Surgery After Neoadjuvant Chemotherapy
21: Surgery After Neoadjuvant Chemotherapy
Introduction
Clinical Trials for Neoadjuvant Chemotherapy and Their Surgical Outcomes
MAGIC
ACCORD
EORTC
Implications of Surgical Outcomes After Neoadjuvant Chemotherapy
Conclusions
References
Part XII: Surgery for Remnant Gastric Cancer
22: Surgery for Remnant Gastric Cancer: Open Surgery
Introduction
Clinicopathologic Characteristics of Remnant Gastric Cancer
Lymph Node Metastases in Remnant Gastric Cancer
Minimally Invasive Treatment for Remnant Gastric Cancer
Endoscopic Treatment
Laparoscopic and Robotic Surgery
Open Surgery for Remnant Gastric Cancer
Treatment Outcomes of Remnant Gastric Cancer
Discussion
References
23: Laparoscopic Surgery
Introduction
Indications
Preoperative Evaluation
Operating Room Setup and Patient Position
Trocar Placement
Surgical Procedures
Patients Who Previously Underwent Billroth I Reconstruction
Patients Who Previously Underwent Billroth II Reconstruction
Our Clinical Experience
Discussion
Short-Term Outcome
Long-Term Outcome
Conclusion
References
Part XIII: Peritonectomy and HIPEC
24: Prevention and Treatment of Peritoneal Metastases from Gastric Cancer
Introduction
Perioperative Intraperitoneal Chemotherapy as an Adjuvant Treatment
Rationale of Perioperative Timing of Intraperitoneal Chemotherapy
Perioperative Chemotherapy with D2 Gastrectomy
Literature Regarding Perioperative Intraperitoneal Chemotherapy for Advanced T-Stage Primary Gastric Cancer
Gastric Cancer with Peritoneal Metastases
CRS and HIPEC as an Effective Strategy
Role of Laparoscopy for Patient Selection
Neoadjuvant Intraperitoneal and Systemic Chemotherapy (NIPS)
Patients Treated
Chemotherapy Regimen
Surgery for Gastric Cancer with Peritoneal Metastases After Neoadjuvant Intraperitoneal and Systemic Chemotherapy (NIPS)
Results After Neoadjuvant Intraperitoneal and Systemic Chemotherapy (NIPS)
Adverse Events from Neoadjuvant Intraperitoneal and Systemic Chemotherapy (NIPS) and Cytoreductive Surgery
Clinical Data Supporting Complete Cytoreduction as the Goal in Management of Gastric Cancer Patients with Peritoneal Seeding
Palliative Benefits to All Patients with Cancerous Ascites
Chemotherapy Agents Selected for Neoadjuvant Intraperitoneal and Systemic Chemotherapy (NIPS)
References
Part XIV: Palliative Surgery (Including Resection, Bypass and Stent)
25: Palliative Therapy for Gastric Cancer
Local Palliative Care
Palliative Gastrectomy
Gastrojejunal Anastomosis
Endoscopic Stent Placement
Palliative Radiotherapy
Endoscopic Laser Therapy
Conclusions and Recommendations
References
Part XV: Postoperative Management and Follow-Up
26: Management of Early Postoperative Complication
Incidence
Risk Factors Related with Early Complication Following Gastrectomy
Early Postoperative Complications
Bleeding (Intra-abdominal, Intraluminal)
Anastomosis Leakage
Obstruction
Pancreatic Abscess and Fistula
Delayed Gastric Emptying
Miscellaneous
Conclusion
References
27: Management of Late Postoperative Complications
Introduction
Functional Disorders
Early Dumping Syndrome
Late Dumping Syndrome
Delayed Gastric Emptying
Roux Stasis Syndrome
Diarrhea
Constipation
Digestion and Absorption Disorders
Lactose Intolerance
Fatty Stool
Anemia
Metabolic Bone Disease
Organic Disorders
Reflux Esophagitis
Anastomotic Ulcers
Anastomotic Stenosis
Cholecystolithiasis and Cholecystitis
Afferent Loop Syndrome
Ileus
Internal Hernia
Evaluation of Postoperative QOL
References
28: Follow-Up After Gastric Cancer Treatment
Introduction
Recurrence Patterns of Gastric Cancer
Timing of Recurrence
Location of Recurrence
Predictive Scoring for Recurrence
Surveillance Modalities
Imaging
Computed Tomography
Magnetic Resonance Imaging and Endoscopic Ultrasound
Positron Emission Tomography/Computed Tomography
Laparoscopy
Endoscopy
Endoscopy After Partial Gastrectomy
Endoscopy After Total Gastrectomy
Endoscopy After Endoscopic Resection
Tumour Markers
Follow-Up and Survival
Other Primary Cancers
Clinical Guidelines and Recommendations
The Future
Nurse-Led Follow-Up
Novel Prognostic and Therapeutic Modalities
Conclusion
References
Part XVI: Neoadjuvant and Adjuvant Treatments for Gastric Cancer
29: Neoadjuvant Treatment for Gastric Cancer
Rationale of Neoadjuvant Treatment
Neoadjuvant Chemotherapy
Perioperative Chemotherapy
Neoadjuvant Chemoradiotherapy
Conclusions
References
30: Adjuvant Treatment for Gastric Cancer
Meta-analysis of Adjuvant Chemotherapy in Gastric Cancer
ACTS-GC Trial
CLASSIC Trial
SAMIT Trial
Concluding Remarks
References
31: Radiation Therapy for Gastric Cancer
Radiation and GI Tract
Preoperative Neoadjuvant Radiation Therapy
Postoperative Adjuvant Radiation Therapy
Patterns of Failure After Surgical Resection
Earlier Prospective Randomized Trials Including INT 0116
Postoperative Chemoradiotherapy in Patients with D2 Gastrectomy
Radiation Targets in D2-Dissected Gastric Cancer
Treatment-Related Complication in Clinical Trials
Palliative Radiation Therapy
References
32: Novel Agents and the Future Perspectives
Introduction
Epidermal Growth Factor Receptor (EGFR)/Human Epidermal Receptor (HER) Inhibitors
Anti-EGFR Monoclonal Antibody (mAbs)
Panitumumab
Cetuximab
Anti-HER2 mAbs
Trastuzumab
Trastuzumab Emtansine (T-DM1)
Pertuzumab
HER2 Tyrosine Kinase Inhibitors (TKIs)
Lapatinib
Angiogenesis Inhibitors
Anti-vascular Endothelial Growth Factor (VEGF) mAbs
Bevacizumab
Ramucirumab
VEGFR TKI
Apatinib
Other Targeted Agents
Mammalian Target of Rapamycin (mTOR) Inhibitors
Mesenchymal-Epithelial Transition Factor (MET) Inhibitors
Rilotumumab
Onartuzumab
Poly ADP-Ribose Polymerase (PARP) Inhibitor
Olaparib
Immunotherapy
PD-1 Inhibitor
Nivolumab
Pembrolizumab
PD-L1 Inhibitor
Conclusions
References
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