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The e-mémoires of the Académie Nationale de Chirurgie

95% (Near Total) Oncolologic Laparoscopic Gastrectomy for Gastric Cancer: Technique, Advantages and Indications

AZAGRA JS | GOERGEN M | ARRU L | ORLANDO GG | SANCHEZ RAMOS A

Seance of wednesday 29 april 2015 (COMMUNICATIONS LIBRES)

Abstract

Total gastrectomy is the standard treatment for tumors arising in the proximal stomach and of diffuse type cancer with "signet-ring cell". The laparoscopic approach is progressively used for the resection of invasive tumors, providing encouraging results when employed in selected patients, by experienced surgeons.In order to reduce the morbidity associated with the esojejunal anastomosis, some Japanese authors have developed the concept of 95 % gastrectomy in the early eighties, which keeps a small gastric stump of 2 cm with the improvement of the early surgical outcomes. Unlike the 7/8 gastrectomy, the 95 % gastrectomy allows the complete resection of the gastric fundus and a complete dissection of lymph node stations 1 and 2. In selected patients, the 95 % gastrectomy could offer the best short-term results and a better quality of life while respecting the actual oncologic criteria regarding proximal resection margins.We describe below our technique of full laparoscopic 95 % gastrectomy, with D2 lymphadenectomy, to our knowledge never documented before.