Issues of lymphadenectomy in laparoscopic gastrectomy for gastric cancer

Abstract

There once remained a controversy concerning the range of lymphadenectomy between Eastern and Western scholars; however, based on the results from 15-year follow-up Dunch trial in 2010, D2 lymphadenectomy has been generally accepted as the standard surgical procedure for gastric cancer treatment. So far, the foundation for laparoscopic lymphadenectomy in gastric cancer surgery has been set up, and a new era of surgical treatment for gastric cancer has arisen. In 1994, Prof. Kitano performed the first laparoscopic surgery for early gastric cancer, since when increasing evidence has proved that laparoscopic surgery can replace partial open surgery and has already been recommended by the Japanese Gastric Cancer Treatment Guidelines as a standard treatment option for early distal gastric cancer. In China, according to the data collected by China Gastrointestinal Cancer Surgery union(CGCSU) from 2014 to 2016, among 88, 000 cases of gastric cancer in 73 centres across the country, the proportion of laparoscopic surgeries have exceeded 30%, accompanied by a yearly rise trend. Laparoscopic surgery is characterized by its minimally invasive, magnified field of vision, fine operation, as well as easier instruction and communication, it will have broad application prospects. This article combines the previous experience of the author team to discuss the issues related to laparoscopic lymphadenectomy. We hope this article could be inspiring to the readers. Key words: Stomach Neoplasms; Laparoscopy; Gastrectomy; Lymph Node Excision