Journal of Surgical Innovation and Education

Dynamic Educational Manuscripts

Laparoscopic Conversion Surgery After Three Years of Palliative Chemotherapy for Unresectable Advanced Gastric Cancer: Ma. Jeanesse C. Bernardo, Mohd Firdaus Che Ani, Zhuang Chun, Abdullah Almayouf, Jee-sun Kim, Tae-Yong Kim, Seong-Ho Kong, Do-Joong Park, Han-Kwang Yang, Hyuk-Joon Lee; J Surg Innov Educ. 2024;1(1):26-27. Published online June 25, 2024; DOI: https://doi.org/10.69474/jsie.2024.00073

Abstract PDF: Unresectable advanced gastric cancer remains a challenge in treatment, often requiring a multidisciplinary approach. Numerous studies have emphasized the role of palliative chemotherapy as the mainstay treatment for unresectable advanced gastric cancers. Some patients may still require conversion surgery to achieve survival gain and palliation. Several recent papers have shown the safety of laparoscopic gastrectomy after neoadjuvant chemotherapy for advanced gastric cancer. However, there is a difference between neoadjuvant chemotherapy and palliative chemotherapy in terms of the duration of chemotherapy (about 3 months vs. more than 6 months) and the initial state of advanced gastric cancer (resectable vs. unresectable and/or metastatic). To date, the safety and efficacy of laparoscopic gastrectomy after long-term palliative chemotherapy has been rarely reported. This video aims to share our experience in performing laparoscopic distal gastrectomy with D2 lymph node dissection after 3 years of palliative chemotherapy for an unresectable advanced gastric cancer.

Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy: Mohd Firdaus Che Ani, Zhuang Chun, Abdullah Almayouf, Jee-sun Kim, Seong-Ho Kong, Do-Joong Park, Han-Kwang Yang, Hyuk-Joon Lee; J Surg Innov Educ. 2024;1(1):28-29. Published online June 25, 2024; DOI: https://doi.org/10.69474/jsie.2024.00059

Abstract PDF: Gastric cancer detection is advancing to a point where screening programs can detect gastric cancer at early stages. This allows surgical procedures to be less radical than before. Studies have proven that pylorus preserving gastrectomy is a safe procedure in early T1a and T1b gastric cancers where the tumour location is in the middle third of the stomach. However, due to the small tumour size, determining an appropriate resection margin can be challenging. A few techniques have been developed to overcome this difficulty, and at our centre, we perform intra-operative gastroscopy to synchronize with the laparoscopic view and precisely determine the tumour location for optimal gastric resections. This allows the gastrectomy to be performed safely and prevents inadequate resection leaving tumour cells behind. This video is aimed at sharing our experience in performing pylorus-preserving gastrectomy.

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