Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2019; 25(14): 1640-1652
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1640
Precision surgical approach with lymph-node dissection in early gastric cancer
Shinichi Kinami, Naohiko Nakamura, Yasuto Tomita, Takashi Miyata, Hideto Fujita, Nobuhiko Ueda, Takeo Kosaka
Shinichi Kinami, Naohiko Nakamura, Yasuto Tomita, Takashi Miyata, Hideto Fujita, Nobuhiko Ueda, Takeo Kosaka, Department of Surgical Oncology, Kanazawa Medical University, Ishikawa 920-0293, Japan
Author contributions: Kinami S is responsible for the scientific context and wrote the manuscript; Nakamura N, Tomita Y, Miyata T, Fujita H, Ueda N, and Kosaka T contributed literature review and analysis, drafting, editing and critical revision, and approval of the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest related to the publication of the study.
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:
Corresponding author: Shinichi Kinami, MD, PhD, Professor, Department of Surgical Oncology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293, Japan.
Telephone: +81-76-2862211 Fax: +81-76-2864626
Received: February 15, 2019
Peer-review started: February 17, 2019
First decision: February 26, 2019
Revised: March 9, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 14, 2019
Core Tip

Core tip: The surgical treatment for early gastric cancer seems to be appropriately radical, because almost all patients can be cured by gastrectomy with lymph-node dissection up to D1+. However, after D1+ gastrectomy, multiple functional symptoms are caused by the loss of the stomach. Physicians must strive to reduce post-gastrectomy symptoms and optimize quality of life. About two-thirds of early gastric cancers are node-negative and can be resected by endoscopic submucosal dissection. The extent of lymph-node dissection can be individualized, and significant gastric preservation can be achieved, with sentinel-node biopsy. The operative method itself is still in transition.