Strategies for gastric cancer in the modern era

Figure 1 Laparoscopy-assisted distal gastrectomy with the voice- controlled robot AESOP. AESOP holds the laparoscope.

Figure 2 Transgastrostomic ultrathin scope passing through the pyloric stricture (A) and percutaneous endoscopic jejunostomy feeding tube placed for palliative therapy (B).

Figure 3 New strategies for gastric cancer. If a patient develops cancer and even if it is diagnosed at an early stage, it may be resectable using less invasive endoscopic submucosal dissection or laparoscopy-assisted gastrectomy (LAG). In the case of advanced stage cancers, instead of open gastrectomy, LAG may also be possible and newer, more effective chemotherapy may be applicable. In case of non-curative advanced gastric cancer, various less invasive therapies may be feasible as best supportive care. m^a: Except for poorly differentiated adenocarcinoma; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; OG: Open gastrectomy; BSC: Best supportive care.