Laparoscopic personalized function-preserving gastrectomy with sentinel node mapping for early-stage gastric cancer

Abstract

Laparoscopic gastrectomy is considered as an indispensable option between endoscopic resection and standard gastrectomy with open laparotomy for patients with early-stage gastric cancer. However, the extent of gastrectomy and remnant gastric function may affect patients’ quality of life (QOL) after surgery. Therefore, function-preserving gastrectomy in addition to laparoscopic surgery could be considered in patients with early-stage gastric cancer. A prospective multicenter trial and meta-analyses of sentinel node (SN) mapping and biopsy for early-stage gastric cancer have demonstrated favorable SN detection rates and accuracy of nodal metastatic status. Although a combination of radioactive colloids with blue dyes as tracers is currently considered as the promising procedure of SN mapping in early-stage gastric cancer, several new technologies, such as indocyanine green fluorescence imaging, may markedly improve its accuracy. For early-stage gastric cancer, the development of laparoscopic personalized minimized gastrectomy with SN mapping may help retain patents’ QOL after surgery. A recently developed full-thickness partial gastrectomy with SN mapping and basin dissection would become a reliable minimally invasive gastrectomy for treating patients with cN0 early-stage gastric cancer.

Keywords

Sentinel node / gastric cancer / laparoscopic / nonexposed endoscopic wall-inversion surgery

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