Laparoscopic right gastroepiploic artery‐sparing distal gastric tube resection with lymph node dissection for gastric tube cancer after esophagectomy: A novel surgical approach (with video)

• DOI: 10.1111/ases.13359
• Publication Date: 2024-08-09T03:47:41Z
• Authors: Hikaru Aoki; Hironori Kawada; Yusuke Hanabata; Akina Shinkura; Kaichiro Harada; Keigo Tachibana; Kento Awane; Keisuke Tanino; Ryuta Nishitai
• Keywords: Left gastric artery; Gastroepiploic Artery; Lymphadenectomy; Right gastroepiploic artery

Abstract Introduction Total resection of the gastric tube with lymphadenectomy for advanced cancer is highly invasive and associated severe complications. Other surgical option, partial gastrectomy or wedge resection, insufficient if lymph node metastasis suspected. Therefore, a technique balancing invasiveness curability required. Materials Surgical Technique First, we laparoscopically peeled off adhesions tube, mesentery (including right gastroepiploic artery/vein), pericardial membrane, aorta, up to planned line. Subsequently, cut infrapyloric arteries at their roots dissected No. 5 6 nodes. We taped spared artery vein tissues including 4d Finally, was using linear stapler, remaining anastomosed jejunum circular stapler. The mean operative time three cases treated this intervention 729 min. patients were discharged on postoperative day 8 9 without any They all remained alive recurrence‐free. Discussion This novel approach balances by leveraging advantages laparoscopy. procedure performed safely reproducibly in consecutive cases, providing another viable option treatment cancer.