Current status of functional gastric surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Qian ¹ , FENG Xingyu ² ,  LI Yong ²

1. Southern Medical University, Guangzhou 510515, P. R. China;
2. Department of General Surgery, Guangdong People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, P. R. China;

Corresponding author：

LI Yong, Email: Yuan821007@126.com

Keywords：

functional preserving gastrectomy; laparascopy gastrectomy; pylorus preserving gastrectomy; pylorus preserving gastrectomy; portal gastrectomy; endoscopy submucosal dissection; endoscopy mucosal resection

DOI：

10.7507/1007-9424.201904002

Video：

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Objective To summarize the research progress of functional surgery in upper and middle gastric cancer.Method " functional gastric surgery” " pylorus-preserving gastrectomy” and " proximal gastrectomy” were used as search terms to retrieve the literatures, and various surgical methods and their application status were reviewed.Results Functional gastric surgery can effectively improve the postoperative quality of life of patients with early gastric cancer in the upper and middle stomach.Conclusion Functional gastric surgery is a feasible surgical method for early gastric cancer.

Citation： YAN Qian, FENG Xingyu, LI Yong. Current status of functional gastric surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(12): 1511-1516. doi: 10.7507/1007-9424.201904002 Copy

1.	Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Prz Gastroenterol, 2019, 14(1): 26-38.
2.	Tsujiura M, Hiki N, Ohashi M, et al. Excellent long-term prognosis and favorable postoperative nutritional status after laparoscopic pylorus-preserving gastrectomy. Ann Surg Oncol, 2017, 24(8): 2233-2240.
3.	Homma Y, Akiyama H, Matsuyama R, et al. Assessment of gastric emptying function after gastrectomy using a real-time ¹³C breath test. Hepatogastroenterology, 2012, 59(119): 2335-2338.
4.	Matsuda T, Nunobe S, Kosuga T, et al. Laparoscopic and luminal endoscopic cooperative surgery can be a standard treatment for submucosal tumors of the stomach: a retrospective multicenter study. Endoscopy, 2017, 49(5): 476-483.
5.	Maki T, Shiratori T, Hatafuku T, et al. Pylorus-preserving gastrectomy as an improved operation for gastric ulcer. Surgery, 1967, 61(6): 838-845.
6.	Kodama M, Koyama K. Indications for pylorus preserving gastrectomy for early gastric cancer located in the middle third of the stomach. World J Surg, 1991, 15(5): 628-633.
7.	Hiki N, Nunobe S, Kubota T, et al. Function-preserving gastrectomy for early gastric cancer. Ann Surg Oncol, 2013, 20(8): 2683-2692.
8.	Nishikawa K, Kawahara H, Yumiba T, et al. Functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy for early gastric cancer. Surgery, 2002, 131(6): 613-624.
9.	Hitoshi Katai. Function-preserving surgery for gastric cancer. Int J Clin Oncol, 2006, 11(5): 357-366.
10.	Shibata C, Shiiba KI, Funayama Y, et al. Outcomes after pylorus-preserving gastrectomy for early gastric cancer: a prospective multicenter trial. World J Surg, 2004, 28(9): 857-861.
11.	Nunobe S, Sasako M, Saka M, et al. Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer, 2007, 10(3): 167-172.
12.	Hiki N, Shimoyama S, Yamaguchi H, et al. Laparoscopyassisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg, 2006, 203(2): 162-169.
13.	Nakajima T, Yamaguchi T. Gastric cancer data-base in Cancer Institute Hospital (1946–2004) with CD-ROM. Tokyo: Kanehara, 2006.
14.	Kim BH, Hong SW, Kim JW, et al. Oncologic safety of pylorus-preserving gastrectomy in the aspect of micrometastasis in lymph nodes at stations 5 and 6. Ann Surg Oncol, 2014, 21(2): 533-538.
15.	Masuzawa T, Takiguchi S, Hirao M, et al. Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer: a multi-institutional retrospective study. World J Surg, 2014, 38(5): 1100-1106.
16.	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer, 2011, 14(2): 113-123.
17.	Kiyokawa T, Hiki N, Nunobe S, et al. Preserving infrapyloric vein reduces postoperative gastric stasis after laparoscopic pylorus-preserving gastrectomy. Langenbecks Arch Surg, 2017, 402(1): 49-56.
18.	Nishizawa N, Hosoda K, Moriya H, et al. Patients’ preoperative background causes gastric stasis after laparoscopy-assisted pylorus-preserving gastrectomy. Asian J Endosc Surg, 2018, 11(4): 337-345.
19.	Furukawa H, Ohashi M, Honda M, et al. Preservation of the celiac branch of the vagal nerve for pylorus-preserving gastrectomy: is it meaningful? Gastric Cancer, 2018, 21(3): 516-523.
20.	Oh SY, Lee HJ, Yang HK. Pylorus-preserving gastrectomy for gastric cancer. J Gastric Cancer, 2016, 16(2): 63-71.
21.	Nakane Y, Michiura T, Inoue K, et al. Length of the antral segment in pylorus-preserving gastrectomy. Br J Surg, 2002, 89(2): 220-224.
22.	Nunobe S, Hiki N, Fukunaga T, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg, 2007, 31(12): 2335-2340.
23.	An JY, Youn HG, Choi MG, et al. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg, 2008, 196(4): 587-591.
24.	Jiang X, Hiki N, Nunobe S, et al. Postoperative outcomes and complications after laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Ann Surg, 2011, 253(5): 928-933.
25.	Hiki N, Sano T, Fukunaga T, et al. Survival benefit of pylorus-preserving gastrectomy in early gastric cancer. J Am Coll Surg, 2009, 209(3): 297-301.
26.	Aizawa M, Honda M, Hiki N, et al. Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy. Gastric Cancer, 2017, 20(4): 709-717.
27.	Sugoor P, Shah S, Dusane R, et al. Proximal gastrectomy versus total gastrectomy for poximal third gastric cancer: totalgastrectomy is not always necessary. Langenbecks Arch Surg, 2016, 401(5): 687-697.
28.	Katai H, Sano T, Fukagawa T, et al. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg, 2003, 90(7): 850-853.
29.	Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer. Surgery, 1998, 123(2): 127-130.
30.	Kinoshita T, Gotohda N, Kato Y, et al. Laparoscopic proximal gastrectomy with jejunal interposition for gastric cancer in the proximal third of the stomach: a retrospective comparison with open surgery. Surg Endosc, 2013, 27(1): 146-153.
31.	Jentschura D, Winkler M, Strohmeier N, et al. Quality-of-life after curative surgery for gastric cancer: a comparison between total gastrectomy and subtotal gastric resection. Hepatogastroenterology, 1997, 44(16): 1137-1142.
32.	Fujita T, Katai H, Morita S, et al. Short-term outcomes of Roux-en-Y stapled anastomosis after distal gastrectomy for gastric adenocarcinoma. J Gastrointest Surg, 2010, 14(2): 289-294.
33.	Gonzalez R, Lin E, Venkatesh KR, et al. Gastrojejunostomy during laparoscopic gastric bypass: analysis of 3 techniques. Arch Surg, 2003, 138(2): 181-184.
34.	Wang H, Hao Q, Wang M, et al. Esophagojejunostomy after laparoscopic total gastrectomy by OrVil^TM or hemi-double stapling technique. World J Gastroenterol, 2015, 21(29): 8943-8951.
35.	Nomura E, Okajima K. Function-preserving gastrectomy for gastric cancer in Japan. World J Gastroenterol, 2016, 22(26): 5888-5895.
36.	Shiraishi N, Hirose R, Morimoto A, et al. Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy. Gastric Cancer, 1998, 1(1): 78-79.
37.	Katai H, Morita S, Saka M, et al. Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach. Br J Surg, 2010, 97(4): 558-562.
38.	Fukuhara T. Control mechanism of the gastrointestinal peristalsis through intramural nerve (in Japanese). Jap J Smooth Muscle Res, 1967, 3: 1-18.
39.	Park YM, Cho E, Kang HY, et al. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc, 2011, 25(8): 2666-2677.
40.	Aburatani T, Kojima K, Otsuki S, et al. Double-tract reconstruction after laparoscopic proximal gastrectomy using detachable ENDO-PSD. Surg Endosc, 2017, 31(11): 4848-4856.
41.	Hong J, Qian L, Wang YP, et al. A novel method of delta-shaped intracorporeal double-tract reconstruction in totally laparoscopicproximal gastrectomy. Surg Endosc, 2016, 30(6): 2396-2403.
42.	Ojima T, Nakamori M, Nakamura M, et al. Fundoplication with 180-degree wrap during esophagogastrostomy after Robotic proximal gastrectomy for early gastric cancer. J Gastrointest Surg, 2018, 22(8): 1475-1476.
43.	Muraoka A, Kobayashi M, Kokudo Y. Laparoscopy-assisted proximal gastrectomy with the hinged double flap method. World J Surg, 2016, 40(10): 2419-2424.
44.	Hayami M, Hiki N, Nunobe S, et al. Clinical outcomes and evaluation of laparoscopic proximal gastrectomy with double-flap technique for early gastric cancer in the upper third of the stomach. Ann Surg Oncol, 2017, 24(6): 1635-1642.
45.	Kuroda S, Nishizaki M, Kikuchi S, et al. Double flap technique as an anti-reflux procedure in esophagogastrostomy after proximal gastrectomy. J Am Coll Surg, 2016, 23(2): e7-e13.
46.	Soetikno RM, Gotoda T, Nakanishi Y, et al. Endoscopic mucosal resection. Gastrointest Endosc, 2003, 57(4): 567-579.
47.	Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy, 2015, 47(9): 829-854.
48.	Lee JH, Hong SJ, Jang JY, et al. Outcome after endoscopic submucosal dissection for early gastric cancer in Korea. World J Gastroenterol, 2011, 17(31): 3591-3595.
49.	Nunobe S, Hiki N, Gotoda T, et al. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer. Gastric Cancer, 2012, 15(3): 338-342.

1. Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Prz Gastroenterol, 2019, 14(1): 26-38.
2. Tsujiura M, Hiki N, Ohashi M, et al. Excellent long-term prognosis and favorable postoperative nutritional status after laparoscopic pylorus-preserving gastrectomy. Ann Surg Oncol, 2017, 24(8): 2233-2240.
3. Homma Y, Akiyama H, Matsuyama R, et al. Assessment of gastric emptying function after gastrectomy using a real-time ¹³C breath test. Hepatogastroenterology, 2012, 59(119): 2335-2338.
4. Matsuda T, Nunobe S, Kosuga T, et al. Laparoscopic and luminal endoscopic cooperative surgery can be a standard treatment for submucosal tumors of the stomach: a retrospective multicenter study. Endoscopy, 2017, 49(5): 476-483.
5. Maki T, Shiratori T, Hatafuku T, et al. Pylorus-preserving gastrectomy as an improved operation for gastric ulcer. Surgery, 1967, 61(6): 838-845.
6. Kodama M, Koyama K. Indications for pylorus preserving gastrectomy for early gastric cancer located in the middle third of the stomach. World J Surg, 1991, 15(5): 628-633.
7. Hiki N, Nunobe S, Kubota T, et al. Function-preserving gastrectomy for early gastric cancer. Ann Surg Oncol, 2013, 20(8): 2683-2692.
8. Nishikawa K, Kawahara H, Yumiba T, et al. Functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy for early gastric cancer. Surgery, 2002, 131(6): 613-624.
9. Hitoshi Katai. Function-preserving surgery for gastric cancer. Int J Clin Oncol, 2006, 11(5): 357-366.
10. Shibata C, Shiiba KI, Funayama Y, et al. Outcomes after pylorus-preserving gastrectomy for early gastric cancer: a prospective multicenter trial. World J Surg, 2004, 28(9): 857-861.
11. Nunobe S, Sasako M, Saka M, et al. Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer, 2007, 10(3): 167-172.
12. Hiki N, Shimoyama S, Yamaguchi H, et al. Laparoscopyassisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg, 2006, 203(2): 162-169.
13. Nakajima T, Yamaguchi T. Gastric cancer data-base in Cancer Institute Hospital (1946–2004) with CD-ROM. Tokyo: Kanehara, 2006.
14. Kim BH, Hong SW, Kim JW, et al. Oncologic safety of pylorus-preserving gastrectomy in the aspect of micrometastasis in lymph nodes at stations 5 and 6. Ann Surg Oncol, 2014, 21(2): 533-538.
15. Masuzawa T, Takiguchi S, Hirao M, et al. Comparison of perioperative and long-term outcomes of total and proximal gastrectomy for early gastric cancer: a multi-institutional retrospective study. World J Surg, 2014, 38(5): 1100-1106.
16. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer, 2011, 14(2): 113-123.
17. Kiyokawa T, Hiki N, Nunobe S, et al. Preserving infrapyloric vein reduces postoperative gastric stasis after laparoscopic pylorus-preserving gastrectomy. Langenbecks Arch Surg, 2017, 402(1): 49-56.
18. Nishizawa N, Hosoda K, Moriya H, et al. Patients’ preoperative background causes gastric stasis after laparoscopy-assisted pylorus-preserving gastrectomy. Asian J Endosc Surg, 2018, 11(4): 337-345.
19. Furukawa H, Ohashi M, Honda M, et al. Preservation of the celiac branch of the vagal nerve for pylorus-preserving gastrectomy: is it meaningful? Gastric Cancer, 2018, 21(3): 516-523.
20. Oh SY, Lee HJ, Yang HK. Pylorus-preserving gastrectomy for gastric cancer. J Gastric Cancer, 2016, 16(2): 63-71.
21. Nakane Y, Michiura T, Inoue K, et al. Length of the antral segment in pylorus-preserving gastrectomy. Br J Surg, 2002, 89(2): 220-224.
22. Nunobe S, Hiki N, Fukunaga T, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg, 2007, 31(12): 2335-2340.
23. An JY, Youn HG, Choi MG, et al. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer. Am J Surg, 2008, 196(4): 587-591.
24. Jiang X, Hiki N, Nunobe S, et al. Postoperative outcomes and complications after laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Ann Surg, 2011, 253(5): 928-933.
25. Hiki N, Sano T, Fukunaga T, et al. Survival benefit of pylorus-preserving gastrectomy in early gastric cancer. J Am Coll Surg, 2009, 209(3): 297-301.
26. Aizawa M, Honda M, Hiki N, et al. Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy. Gastric Cancer, 2017, 20(4): 709-717.
27. Sugoor P, Shah S, Dusane R, et al. Proximal gastrectomy versus total gastrectomy for poximal third gastric cancer: totalgastrectomy is not always necessary. Langenbecks Arch Surg, 2016, 401(5): 687-697.
28. Katai H, Sano T, Fukagawa T, et al. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg, 2003, 90(7): 850-853.
29. Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer. Surgery, 1998, 123(2): 127-130.
30. Kinoshita T, Gotohda N, Kato Y, et al. Laparoscopic proximal gastrectomy with jejunal interposition for gastric cancer in the proximal third of the stomach: a retrospective comparison with open surgery. Surg Endosc, 2013, 27(1): 146-153.
31. Jentschura D, Winkler M, Strohmeier N, et al. Quality-of-life after curative surgery for gastric cancer: a comparison between total gastrectomy and subtotal gastric resection. Hepatogastroenterology, 1997, 44(16): 1137-1142.
32. Fujita T, Katai H, Morita S, et al. Short-term outcomes of Roux-en-Y stapled anastomosis after distal gastrectomy for gastric adenocarcinoma. J Gastrointest Surg, 2010, 14(2): 289-294.
33. Gonzalez R, Lin E, Venkatesh KR, et al. Gastrojejunostomy during laparoscopic gastric bypass: analysis of 3 techniques. Arch Surg, 2003, 138(2): 181-184.
34. Wang H, Hao Q, Wang M, et al. Esophagojejunostomy after laparoscopic total gastrectomy by OrVil^TM or hemi-double stapling technique. World J Gastroenterol, 2015, 21(29): 8943-8951.
35. Nomura E, Okajima K. Function-preserving gastrectomy for gastric cancer in Japan. World J Gastroenterol, 2016, 22(26): 5888-5895.
36. Shiraishi N, Hirose R, Morimoto A, et al. Gastric tube reconstruction prevented esophageal reflux after proximal gastrectomy. Gastric Cancer, 1998, 1(1): 78-79.
37. Katai H, Morita S, Saka M, et al. Long-term outcome after proximal gastrectomy with jejunal interposition for suspected early cancer in the upper third of the stomach. Br J Surg, 2010, 97(4): 558-562.
38. Fukuhara T. Control mechanism of the gastrointestinal peristalsis through intramural nerve (in Japanese). Jap J Smooth Muscle Res, 1967, 3: 1-18.
39. Park YM, Cho E, Kang HY, et al. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc, 2011, 25(8): 2666-2677.
40. Aburatani T, Kojima K, Otsuki S, et al. Double-tract reconstruction after laparoscopic proximal gastrectomy using detachable ENDO-PSD. Surg Endosc, 2017, 31(11): 4848-4856.
41. Hong J, Qian L, Wang YP, et al. A novel method of delta-shaped intracorporeal double-tract reconstruction in totally laparoscopicproximal gastrectomy. Surg Endosc, 2016, 30(6): 2396-2403.
42. Ojima T, Nakamori M, Nakamura M, et al. Fundoplication with 180-degree wrap during esophagogastrostomy after Robotic proximal gastrectomy for early gastric cancer. J Gastrointest Surg, 2018, 22(8): 1475-1476.
43. Muraoka A, Kobayashi M, Kokudo Y. Laparoscopy-assisted proximal gastrectomy with the hinged double flap method. World J Surg, 2016, 40(10): 2419-2424.
44. Hayami M, Hiki N, Nunobe S, et al. Clinical outcomes and evaluation of laparoscopic proximal gastrectomy with double-flap technique for early gastric cancer in the upper third of the stomach. Ann Surg Oncol, 2017, 24(6): 1635-1642.
45. Kuroda S, Nishizaki M, Kikuchi S, et al. Double flap technique as an anti-reflux procedure in esophagogastrostomy after proximal gastrectomy. J Am Coll Surg, 2016, 23(2): e7-e13.
46. Soetikno RM, Gotoda T, Nakanishi Y, et al. Endoscopic mucosal resection. Gastrointest Endosc, 2003, 57(4): 567-579.
47. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T, et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy, 2015, 47(9): 829-854.
48. Lee JH, Hong SJ, Jang JY, et al. Outcome after endoscopic submucosal dissection for early gastric cancer in Korea. World J Gastroenterol, 2011, 17(31): 3591-3595.
49. Nunobe S, Hiki N, Gotoda T, et al. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer. Gastric Cancer, 2012, 15(3): 338-342.

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