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Japanese
ExperienceofLaparoscopicOncologicGastrectomyNobuhikoTanigawa,MD,FACSandKyoichiTakaori,MDDepartmentofGeneralandGastroenterologicalSurgeryOsakaMedicalCollege,Osaka,JapanAtPekingUniversityApril6th2005JapaneseExperienceofNobuhi0200400600800100012001400'91'92'93'94'95'96'97'98'99'00'01TotalgastrectomyProximalgastrectomyDistalgastrectomy
(D2ormore)Distalgastrectomy
(D1+α)Distalgastrectomy
(D1)LocalresectionIntragastricsurgeryLaparoscopicSurgeryforGastricCancerinJapan（year）（cases）(7thNationwideSurvey,2004,JSES)Miscellaneous‘02’03160018002000Distalgastrectomy
(D1+β)0200400600800100012001400'91'90200400600800100012001400'91'92'93'94'95'96'97'98'99'00'01TotalgastrectomyProximalgastrectomyDistalgastrectomy
(D2ormore)Distalgastrectomy
(D1+α)Distalgastrectomy
(D1)LocalresectionIntragastricsurgeryLaparoscopicSurgeryforGastricCancerinJapan（year）（cases）(7thNationwideSurvey,2004,JSES)Miscellaneous‘02’03160018002000Distalgastrectomy
(D1+β)0200400600800100012001400'91'9Islymphnodedissectionforearlygastriccancernecessary?
Islymphnodedissectionfor0.90.90.72.73.30.55.20.8PercentincidenceofregionallymphnodemetastasisfromT1(sm)cancer(L)0.9Group1nodesGroup2nodes(OMCexperiencein1978～2000)0.90.90.72.73.30.55.20.8Percen2.21.10.64.42.50.51.70.8PercentincidenceofregionallymphnodemetastasisfromT1(sm)cancer(M)0.32.70.9Group1nodesGroup2nodes(OMCexperiencein1978～2000)2.21.10.64.42.50.51.70.8PercenIslymphnodedissectionforearlygastriccancernecessary?
“Yes,itis.”Islymphnodedissectionfor“
N0
N1
N2
N3T1(M)T1(SM)T2T3T4H1,P1,CY1,M1,ⅠAEMR
(Welldiff.,<2.0cm,UL(－))GastrectomywithD1+α
ⅠAGastrectomywithD1+α
(Welldiff,＜1.5cm)GastrectomywithD1+βⅠBGastrectomywithD2ⅡGastrectomywithD2ⅢAExtendedSurgery
ⅠBGastrectomywithD1+β(＜2.0.ｃｍ)GastrectomywithD2(>2.１.ｃｍ)ⅡGastrectomywithD2ⅢAGastrectomywithD2ⅢBExtendedSurgeryⅡGastrectomy+D2ⅢAGastrectomy+D2ⅢBGastrectomy+D2ⅣExtendedSurgPalliativeSurgChemotherapyRadiationtherGuidelinesforGastricCancerTreatment(2001)：
RecommendableModeofTreatmentdefinedbyDiseaseStage(StandardCare,andN0
N0
N1
N2
N3T1(M)T1(SM)T2T3T4H1,P1,CY1,M1,ⅠAEMR
(Welldiff.,<2.0cm,UL(－))GastrectomywithD1+αLaparosopicgastrectomy
ⅠAGastrectomywithD1+α
(Welldiff,＜1.5cm)GastrectomywithD1+βLaparosopicgastrectomyⅠBLaparosopicgastrectomyGastrectomywithD2ⅡGastrectomywithD2ⅢAExtendedSurgery
ⅠBGastrectomywithD1+β(>2.0.ｃｍ)GastrectomywithD2(>2.１.ｃｍ)LaparosopicgastrectomyⅡGastrectomywithD2ⅢAGastrectomywithD2ⅢBExtendedSurgeryⅡGastrectomy+D2ⅢAGastrectomy+D2ⅢBGastrectomy+D2ⅣExtendedSurgPalliativeSurgChemotherapyRadiationtherGuidelinesforGastricCancerTreatment(2001)：
RecommendableModeofTreatmentdefinedbyDiseaseStage(StandardCare,andInvestigationalTreatment)N0AdvancedCancer
StrategyforGCTreatment
MucosalCancer●EMRLaparoscopicSurgeryOpenSurgery(OMC
2004)SubmucosalCancerAdvancedCancerStrategyforGLapGastrectomyforEarlyCancer
(1,622casesin21leadinginstitutions)WedgeResection96(6%)InragastricResection35(2%)TotalGastrectomy66(4%)DistalGastrectomy1,218(75%)PylorusPreservingGastrectomy
131(8%)ProximalGastrectomy76(5%)(LapStudyGroupfundedbyJpMinistryofHealth,WelfareandLaborSeptember,2004)LapGastrectomyforEarlyCancComplicationsinJapanesenationwideexperienceoflap-DGStomalstenosis 103/2600(3.9)Woundinfection 45/2600(1.7)Anastomoticleakage 43/2600(1.6)Pancreatitisorfistula 17/2600(0.6)Bleeding 13/2600(0.5)Ileus 13/2600(0.5)Peritonealabscess8/2600(0.3)No.ofPatients(%)ComplicationsinJapanesenati55512ポート位置55512ポート位置LymphnodedissectionaroundLGEvesselsLGEVLGEVLymphnodedissectionaroundLLymphnodedissectionaroundRGEvesselsGDARGEALymphnodedissectionaroundRLymphnodedissectionaroundRGvessels
(fromanterioraspect)LymphnodedissectionaroundRLymphnodedissectionaroundPHAPHALymphnodedissectionaroundPLymphnodedissectionaroundCHA,LGA,SpAandCeACHAPancreasLymphnodedissectionaroundCLymphnodedissectionaroundSMV(14v)LymphnodedissectionaroundS当科のRoux-Y再建手技当科のRoux-Y再建手技腹腔鏡下胃癌手術後の腹壁の傷腹腔鏡下胃癌手術後の腹壁の傷MedianNumberofRetrievedLymphNodes,BloodLoss,andOperativeTimeinOpenandLaparoscopicDistalGastrectomyGroup1lymphnodes21.720.0
Open-DG(n=394)Lap-DG(n=68)Group2lymphnodes16.912.5Bloodloss(ml)225180Operativetime(min)202331
/total/38.6/32.5
MedianNumberofRetrievedLymConclusion-LDGingeneralWithrecentadventofinstrumentation,laparoscopicapproachisincreasinglyappliedforpatientswithearlycancer.
Properextentoflymphnodedissectionforearlycancerappearsfeasiblewithkeepinglowerincidenceofmorbidity.However,oncologicadequacyoflymphnodedissectionisnotprovedatpresent.Conclusion-LDGingeneralWi后面内容直接删除就行资料可以编辑修改使用资料可以编辑修改使用后面内容直接删除就行主要经营：网络软件设计、图文设计制作、发布广告等公司秉着以优质的服务对待每一位客户，做到让客户满意！主要经营：网络软件设计、图文设计制作、发布广告等致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划案、学习课件、各类模板等方方面面，打造全网一站式需求致力于数据挖掘，合同简历、论文写作、PPT设计、计划书、策划感谢您的观看和下载Theusercandemonstrateonaprojectororcomputer,orprintthepresentationandmakeitintoafilmtobeusedinawiderfield感谢您的观看和下载Theusercandemonstr
Japanese
ExperienceofLaparoscopicOncologicGastrectomyNobuhikoTanigawa,MD,FACSandKyoichiTakaori,MDDepartmentofGeneralandGastroenterologicalSurgeryOsakaMedicalCollege,Osaka,JapanAtPekingUniversityApril6th2005JapaneseExperienceofNobuhi0200400600800100012001400'91'92'93'94'95'96'97'98'99'00'01TotalgastrectomyProximalgastrectomyDistalgastrectomy
(D2ormore)Distalgastrectomy
(D1+α)Distalgastrectomy
(D1)LocalresectionIntragastricsurgeryLaparoscopicSurgeryforGastricCancerinJapan（year）（cases）(7thNationwideSurvey,2004,JSES)Miscellaneous‘02’03160018002000Distalgastrectomy
(D1+β)0200400600800100012001400'91'90200400600800100012001400'91'92'93'94'95'96'97'98'99'00'01TotalgastrectomyProximalgastrectomyDistalgastrectomy
(D2ormore)Distalgastrectomy
(D1+α)Distalgastrectomy
(D1)LocalresectionIntragastricsurgeryLaparoscopicSurgeryforGastricCancerinJapan（year）（cases）(7thNationwideSurvey,2004,JSES)Miscellaneous‘02’03160018002000Distalgastrectomy
(D1+β)0200400600800100012001400'91'9Islymphnodedissectionforearlygastriccancernecessary?
Islymphnodedissectionfor0.90.90.72.73.30.55.20.8PercentincidenceofregionallymphnodemetastasisfromT1(sm)cancer(L)0.9Group1nodesGroup2nodes(OMCexperiencein1978～2000)0.90.90.72.73.30.55.20.8Percen2.21.10.64.42.50.51.70.8PercentincidenceofregionallymphnodemetastasisfromT1(sm)cancer(M)0.32.70.9Group1nodesGroup2nodes(OMCexperiencein1978～2000)2.21.10.64.42.50.51.70.8PercenIslymphnodedissectionforearlygastriccancernecessary?
“Yes,itis.”Islymphnodedissectionfor“
N0
N1
N2
N3T1(M)T1(SM)T2T3T4H1,P1,CY1,M1,ⅠAEMR
(Welldiff.,<2.0cm,UL(－))GastrectomywithD1+α
ⅠAGastrectomywithD1+α
(Welldiff,＜1.5cm)GastrectomywithD1+βⅠBGastrectomywithD2ⅡGastrectomywithD2ⅢAExtendedSurgery
ⅠBGastrectomywithD1+β(＜2.0.ｃｍ)GastrectomywithD2(>2.１.ｃｍ)ⅡGastrectomywithD2ⅢAGastrectomywithD2ⅢBExtendedSurgeryⅡGastrectomy+D2ⅢAGastrectomy+D2ⅢBGastrectomy+D2ⅣExtendedSurgPalliativeSurgChemotherapyRadiationtherGuidelinesforGastricCancerTreatment(2001)：
RecommendableModeofTreatmentdefinedbyDiseaseStage(StandardCare,andN0
N0
N1
N2
N3T1(M)T1(SM)T2T3T4H1,P1,CY1,M1,ⅠAEMR
(Welldiff.,<2.0cm,UL(－))GastrectomywithD1+αLaparosopicgastrectomy
ⅠAGastrectomywithD1+α
(Welldiff,＜1.5cm)GastrectomywithD1+βLaparosopicgastrectomyⅠBLaparosopicgastrectomyGastrectomywithD2ⅡGastrectomywithD2ⅢAExtendedSurgery
ⅠBGastrectomywithD1+β(>2.0.ｃｍ)GastrectomywithD2(>2.１.ｃｍ)LaparosopicgastrectomyⅡGastrectomywithD2ⅢAGastrectomywithD2ⅢBExtendedSurgeryⅡGastrectomy+D2ⅢAGastrectomy+D2ⅢBGastrectomy+D2ⅣExtendedSurgPalliativeSurgChemotherapyRadiationtherGuidelinesforGastricCancerTreatment(2001)：
RecommendableModeofTreatmentdefinedbyDiseaseStage(StandardCare,andInvestigationalTreatment)N0AdvancedCancer
StrategyforGCTreatment
MucosalCancer●EMRLaparoscopicSurgeryOpenSurgery(OMC
2004)SubmucosalCancerAdvancedCancerStrategyforGLapGastrectomyforEarlyCancer
(1,622casesin21leadinginstitutions)WedgeResection96(6%)InragastricResection35(2%)TotalGastrectomy66(4%)DistalGastrectomy1,218(75%)PylorusPreservingGastrectomy
131(8%)ProximalGastrectomy76(5%)(LapStudyGroupfundedbyJpMinistryofHealth,WelfareandLaborSeptember,2004)LapGastrectomyforEarlyCancComplicationsinJapanesenationwideexperienceoflap-DGStomalstenosis 103/2600(3.9)Woundinfection 45/2600(1.7)Anastomoticleakage 43/2600(1.6)Pancreatitisorfistula 17/2600(0.6)Bleeding 13/2600(0.5)Ileus 13/2600(0.5)Peritonealabscess8/2600(0.3)No.ofPatients(%)ComplicationsinJapanesenati55512ポート位置55512ポート位置LymphnodedissectionaroundLGEvesselsLGEVLGEVLymphnodedissectionaroundLLymphnodedissectionaroundRGEvesselsGDARGEALymphnodedissectionaroundRLymphnodedissectionaroundRGvessels
(fromanterioraspect)LymphnodedissectionaroundRLymphnodedissectionaroundPHAPHALymphnodedissectionaroundPLymphnodedissectionaroundCHA,LGA,SpAandCeACHAPancreasLymphnodedissectionaroundCLymphnodedissectionaroundSMV(14v)LymphnodedissectionaroundS当科のRoux-Y再建手技当科のRoux-Y再建手技腹腔鏡下胃癌手術後の腹壁
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