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World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1154-1165
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1154
Present situation of minimally invasive surgical treatment for early gastric cancer
Chun-Yan Li, Yi-Feng Wang, Li-Kang Luo, Xiao-Jun Yang
Chun-Yan Li, Xiao-Jun Yang, The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
Yi-Feng Wang, Li-Kang Luo, The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, General Surgery Clinical Centre, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, The Second Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, Lanzhou University People's Clinical Hospital, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Xiao-Jun Yang, Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Co-first authors: Chun-Yan Li and Yi-Feng Wang.
Author contributions: Li CY and Wang YF contributed conceptualization; Li CY and Luo LK contributed methodology; Yang XJ contributed formal analysis, supervision and funding acquisition; Li CY contributed investigation; Wang YF contributed resources; Luo LK contributed data curation and visualization; Li CY contributed original draft preparation; Li CY and Wang YF contributed review and editing; Luo LK and Yang XJ contributed project administration; all authors have read and agreed to the published version of the manuscript.
Supported by Key R&D projects of provincial science and technology plans of Gansu Province, No. 21YF5WA027; Scientific Research Program of Health Industry of Gansu Province, No. GSWSKY2020-45; Gansu Provincial People's Hospital Intramural Research Fund Program, No. 22GSSYD-61; Grants from Innovation Base and Talent Project of Gansu Province, No. 20JR10RA433; and The 2021 Central-Guided Local Science and Technology Development Fund, No. ZYYDDFFZZJ-1.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Jun Yang, MD, Associate Professor, Chief Physician, General Surgery Clinical Centre, Gansu Provincial Hospital, No. 204 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu Province, China. yangxjmd@aliyun.com
Received: September 20, 2023
Peer-review started: September 20, 2023
First decision: November 22, 2023
Revised: December 5, 2023
Accepted: February 2, 2024
Article in press: February 2, 2024
Published online: April 15, 2024
Processing time: 203 Days and 9.6 Hours
Abstract

Minimally invasive surgery is a kind of surgical operation, which is performed by using professional surgical instruments and equipment to inactivate, resect, repair or reconstruct the pathological changes, deformities and wounds in human body through micro-trauma or micro-approach, in order to achieve the goal of treatment, its surgical effect is equivalent to the traditional open surgery, while avoiding the morbidity of conventional surgical wounds. In addition, it also has the advantages of less trauma, less blood loss during operation, less psychological burden and quick recovery on patients, and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients. Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer (EGC): endoscopic mucosal resection (EMR), underwater EMR (UEMR), endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFTR), endoscopic submucosal excavation (ESE), submucosal tunnel endoscopic resection), laparoscopic and endoscopic cooperative surgery (LECS); Among them, EMR, EFTR and LECS technologies have a wide range of applications and different modifications have been derived from their respective surgical operations, such as band-assisted EMR (BA-EMR), conventional EMR (CEMR), over-the-scope clip-assisted EFTR, no-touch EFTR, the inverted LECS, closed LECS, and so on. These new and improved minimally invasive surgeries are more precise, specific and effective in treating different types of EGC.

Keywords: Minimally invasive surgery; Early gastric cancer; Endoscopic mucosal resection; Endoscopic full-thickness resection; Laparoscopic and endoscopic cooperative surgery

Core Tip: In this article the authors provide an overview of the surgical forms of minimally invasive surgical treatment performed for early gastric cancer in recent years, adding newly popular surgical procedures such as band-assisted endoscopic mucosal resection (EMR), EMR with circumferential precutting, modified cap-assisted EMR, underwater EMR, ligation-assisted endoscopic full-thickness resection (EFTR), over-the-scope clip-assisted EFTR, no-touch EFTR, non-exposure simple suturing EFTR, exposed EFTR, and so on.