| Theme | Clinical Gastroenterology -- Past 30 Years and Future Vision | |
|---|---|---|
| Title | Historical Review and Future Perspective of Surgery in Gastric Diseases | |
| Publish Date | 2015/01 | |
| Author | Mitsuru Sasako | Upper Gastrointestinal Surgery, Hyogo Medical College |
| [ Summary ] | Due to the development of drug therapies in the last four decades, surgery is seldom used for gastric and/or duodenal ulcers or malignant lymphoma. The majority of early gastric cancers are now treated with endoscopic submucosal dissection. Pylorus preserving distal gastrectomy has been established as a type of function preserving surgery. Laparoscopic gastrectomy has become popular but lacks evidence concerning its efficacy as a form of oncological surgery providing better quality of life in the long‒term. Application of super extended surgery is restricted, with D2 dissection being the established standard form of lymphadenectomy. In the near future, a combination of pre‒operative intensive chemotherapy and extended surgery may cure gastric cancer patients with M1 diseases or borderline resectable conditions. Large GISTs which are unresectable will become curable with neo‒adjuvant chemotherapy. |
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