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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2016; 22(2): 727-735
Published online Jan 14, 2016. doi: 10.3748/wjg.v22.i2.727
Laparoscopic gastric cancer surgery: Current evidence and future perspectives
Taeil Son, Woo Jin Hyung
Taeil Son, Woo Jin Hyung, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea
Taeil Son, Woo Jin Hyung, Gastric Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University Health System, Seoul 120-752, South Korea
Taeil Son, Woo Jin Hyung, Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul 120-752, South Korea
Author contributions: All authors contributed to this manuscript.
Supported by ETRI R&D Program (14ZC1400, The Development of a Realistic Surgery Rehearsal System based on Patient Specific Surgical Planning), funded by the Government of South Korea.
Conflict-of-interest statement: Taeil Son has no conflicts of interest or financial obligations to disclose. Woo Jin Hyung has received fees for serving as a consultant for Ethicon, LLC.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Woo Jin Hyung, MD, PhD, Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 120-752, South Korea. wjhyung@yuhs.ac
Telephone: +82-2-22282100 Fax: +82-2-3138289
Received: May 28, 2015
Peer-review started: May 31, 2015
First decision: July 14, 2015
Revised: August 16, 2015
Accepted: November 19, 2015
Article in press: November 19, 2015
Published online: January 14, 2016
Processing time: 223 Days and 15.3 Hours
Abstract

Laparoscopic gastrectomy has been widely accepted as a standard alternative for the treatment of early-stage gastric adenocarcinoma because of its favorable short-term outcomes. Although controversies exist, such as establishing clear indications, proper preoperative staging, and oncologic safety, experienced surgeons and institutions have applied this approach, along with various types of function-preserving surgery, for the treatment of advanced gastric cancer. With technical advancement and the advent of state-of-the-art instruments, indications for laparoscopic gastrectomy are expected to expand as far as locally advanced gastric cancer. Laparoscopic gastrectomy appears to be promising; however, scientific evidence necessary to generalize this approach to a standard treatment for all relevant patients and care providers remains to be gathered. Several multicenter, prospective randomized trials in high-incidence countries are ongoing, and results from these trials will highlight the short- and long-term outcomes of the approach. In this review, we describe up-to-date findings and critical issues regarding laparoscopic gastrectomy for gastric cancer.

Keywords: Gastrectomy; Laparoscopic resection; Early gastric cancer; Stomach neoplasms; Advanced gastric cancer; Minimally invasive surgery

Core tip: Laparoscopic gastrectomy has been widely accepted as a standard alternative to open gastrectomy for the treatment of early gastric cancer. Its clinical indications are expanding to include more extensive surgeries along with more sophisticated conserving or function-preserving surgeries. Although some controversies limit extensive application of the procedure, including a lack of evidence of oncologic safety and discrepancy between high- and low-incidence countries, laparoscopic gastrectomy for gastric adenocarcinoma could become widespread as new technologies, improved surgical techniques, and evidence from ongoing multicenter trials emerge.