Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2019; 25(14): 1640-1652
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1640
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1640
Precision surgical approach with lymph-node dissection in early gastric cancer
Shinichi Kinami, Naohiko Nakamura, Yasuto Tomita, Takashi Miyata, Hideto Fujita, Nobuhiko Ueda, Takeo Kosaka, Department of Surgical Oncology, Kanazawa Medical University, Ishikawa 920-0293, Japan
Author contributions: Kinami S is responsible for the scientific context and wrote the manuscript; Nakamura N, Tomita Y, Miyata T, Fujita H, Ueda N, and Kosaka T contributed literature review and analysis, drafting, editing and critical revision, and approval of the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest related to the publication of the study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shinichi Kinami, MD, PhD, Professor, Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293, Japan. kinami@kanazawa-med.ac.jp
Telephone: +81-76-2862211 Fax: +81-76-2864626
Received: February 15, 2019
Peer-review started: February 17, 2019
First decision: February 26, 2019
Revised: March 9, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 14, 2019
Peer-review started: February 17, 2019
First decision: February 26, 2019
Revised: March 9, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 14, 2019
Core Tip
Core tip: The surgical treatment for early gastric cancer seems to be appropriately radical, because almost all patients can be cured by gastrectomy with lymph-node dissection up to D1+. However, after D1+ gastrectomy, multiple functional symptoms are caused by the loss of the stomach. Physicians must strive to reduce post-gastrectomy symptoms and optimize quality of life. About two-thirds of early gastric cancers are node-negative and can be resected by endoscopic submucosal dissection. The extent of lymph-node dissection can be individualized, and significant gastric preservation can be achieved, with sentinel-node biopsy. The operative method itself is still in transition.