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World J Gastroenterol. Oct 21, 2014; 20(39): 14280-14291
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14280
Laparoscopic gastric surgery for cancer: Where do we stand?
Pantelis T Antonakis, Hutan Ashrafian, Alberto Martinez Isla
Pantelis T Antonakis, General Surgeon, Department of Surgery, Athens Euroclinic, 11521 Athens, Greece
Hutan Ashrafian, Lecturer in Surgery, Department of Surgery and Cancer, Imperial College London, London W2 1NY, United Kingdom
Hutan Ashrafian, Alberto Martinez Isla, Department of Upper GI Surgery, Northwick Park-St Marks Hospital, London HA1 3UJ, United Kingdom
Author contributions: Antonakis PT performed the research and wrote the paper, under close supervision and guidance from Isla AM; Ashrafian H contributed to the writing of this manuscript; Isla AM edited the completed manuscript; Antonakis PT, Ashrafian H and Isla AM contributed equally to this work.
Correspondence to: Alberto Martinez Isla, FRCS, Consultant Surgeon, Department of Upper GI Surgery, Northwick Park-St Marks Hospital, Watford Rd, Harrow, London HA1 3UJ, United Kingdom. a.isla@imperial.ac.uk
Telephone: +44-20-84532619 Fax: +44-20-82425912
Received: December 2, 2013
Revised: March 6, 2014
Accepted: May 28, 2014
Published online: October 21, 2014
Abstract

Gastric cancer poses a significant public health problem, especially in the Far East, due to its high incidence in these areas. Surgical treatment and guidelines have been markedly different in the West, but nowadays this debate is apparently coming to an end. Laparoscopic surgery has been employed in the surgical treatment of gastric cancer for two decades now, but with controversies about the extent of resection and lymphadenectomy. Despite these difficulties, the apparent advantages of the laparoscopic approach helped its implementation in early stage and distal gastric cancer, with an increase on the uptake for distal gastrectomy for more advanced disease and total gastrectomy. Nevertheless, there is no conclusive evidence about the laparoscopic approach yet. In this review article we present and analyse the current status of laparoscopic surgery in the treatment of gastric cancer.

Keywords: Gastric cancer, Laparoscopic gastrectomy, Minimally invasive gastrectomy, Laparoscopic distal gastrectomy, Laparoscopic total gastrectomy, Robotic gastrectomy

Core tip: The laparoscopic practice for gastric cancer is growing worldwide; primarily for distal early tumours and to a lesser extent for advanced and/or proximal lesions. The supporting evidence for the extent of the resection and the minimally invasive approach has yet to become conclusive. In view of these limitations and the future perspectives, the current status of laparoscopic surgery in the treatment of gastric cancer is presented herein.