Compliance to D2 lymphadenectomy in laparoscopic gastrectomy

Updates Surg. 2018 Jun;70(2):197-205. doi: 10.1007/s13304-018-0553-1. Epub 2018 Jun 20.

Abstract

The objective of this study is to describe the compliance to D2 lymphadenectomy in laparoscopic gastrectomy. Radical partial or total gastrectomy with modified D2 lymphadenectomy is the standard of care for locally advanced gastric cancer. It is unclear whether compliance to D2 lymphadenectomy in laparoscopy is comparable to that in open surgery. A review of the literature was performed and results are described in a descriptive review. Available randomized trials are mostly performed for early gastric cancer, for which formal D2 lymphadenectomy is usually not required. Most trials report no differences in number of retrieved lymph nodes between open and laparoscopic gastrectomy. Only one trial used adherence to D2 lymphadenectomy as primary outcome parameter, and found no difference between laparoscopic and open gastrectomy. Results from randomized trials in advanced gastric cancer are awaited. In the meantime, the laparoscopic approach can be used in experienced centers.

Keywords: Gastric cancer; Lymphadenectomy; Minimally invasive surgery.

Publication types

  • Review

MeSH terms

  • Evidence-Based Medicine
  • Gastrectomy / methods*
  • Guideline Adherence*
  • Humans
  • Laparoscopy / methods*
  • Lymph Node Excision / methods*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Practice Guidelines as Topic*
  • Randomized Controlled Trials as Topic
  • Standard of Care
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome