Evidence - Gastrectomy

• The extent of the resection can already be planned before surgery based on the histomorphological  Laurén classification (1, 2).
• In adenocarcinoma of the gastroesophageal junction (AEG II/III), particularly in locally advanced tumors and following preoperative chemotherapy, frozen section of the proximal resection margin should be obtained (5).
• Resection of an adequate number of lymph nodes, even if benign, (7) may be beneficial.
• At present, the lack of randomized trials does not allow assessment of the role of laparoscopic resection (1, 3).
• The postulated benefits of preserving duodenal transit have not been proven. Pouch formation/gastric replacement is advocated, although few meaningful trials are available (2).

A Prospective, Multicenter, Randomized, Controlled Study of the Clinical Efficacy of Robotic and Laparoscopic Radical Total Gastrectomy in Locally Advanced Middle and Upper Gastric Cancer

Randomized Controlled Trials on Clinical Outcomes of Total Robotic Versus Robotic Assisted Distal Gastrectomy for Gastric Cancer

Comparison the Short and Long-term Outcome of Patients With Gastric Cancer Who Underwent Reduced Port Laparoscopic Gastrectomy With Patients Underwent Traditional Laparoscopic Gastrectomy

1.  
   1. Brennan MF (2005): Current status of surgery for gastric cancer: a review. Gastric Cancer 8:64-70
   2. Chin AC, Espat NJ (2003): Total gastrectomy: options for restoration of gastrointestinal conituitiy. Lancet Oncol 4:271-276
   3. Huscher CG, Mingoli A, Szarzini G et al. (2007): Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer: early and long-term results of a 100-patient series. Am J Surg 194:839-844
   4. Lehnert T, Buhl K (2004): Techniques of reconstruction after total gastectomy for cancer. Br J Surg 91:528-539
   5. Meyer HJ, Opitz G (2007): Aktuelle chirurgische Therapiestrategien beim Magenkarzinom. Verdauungskrankheiten 25:112-121
   6. Mönig SP, Lübke T, Baldus SE (2005): Primärtherapie des Magenkarzinoms. Onkologe 11:630-639
   7. Siewert JR, Kestlmeier R, Busch R et al. (1996): Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases. Br J Surg 83:1144-1147