Korean J Gastrointest Endosc.  2010 Feb;40(2):90-96.

The Efficacy of Diagnostic and Therapeutic Laparoscopic Lymph Node Dissection after Endoscopic Submucosal Dissection in Early Gastric Cancer Laparoscopic Lymph Node Dissection after ESD in EGC

Affiliations
  • 1Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea. cjy6695@dreamwiz.com
  • 2Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Soonchunhyang University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Lymph node metastasis is infrequently found in patients with early gastric cancer (EGC) following surgery. Accurate evaluation of lymph node status is very important in determining the appropriate treatment for patients with EGC. The efficacy of diagnostic and therapeutic laparoscopic lymph node dissection after endoscopic submucosal dissection in patients with EGC at high risk for lymph node metastasis was evaluated.
METHODS
Among patients with EGC who underwent endoscopic submucosal dissection between November 2006 and February 2009, 9 patients with undifferentiated adenocarcinoma, submucosal cancer, immunohistochemically-positive cytoplasmic staining for vascular endothelial growth factor, lymphovascular invasion, a high lymphatic microvessel density, or high microvessel density were selected. All patients underwent laparoscopic lymph node dissection for determination of lymph node status. The local IRB approved the study.
RESULTS
All of the dissected lymph nodes were free of cancer cells in all of the patients. During 16 months of follow-up, no patients had evidence of tumor recurrence.
CONCLUSIONS
Laparoscopic lymph node dissection after endoscopic submucosal dissection is useful to assess lymph node status and may help guide further treatment for patients with EGC at high risk for lymph node metastasis.

Keyword

Stomach neoplasm; Lymph nodes; Gastroscopic surgery; Laparoscopic surgery; Immunohistochemistry

MeSH Terms

Adenocarcinoma
Cytoplasm
Ethics Committees, Research
Follow-Up Studies
Gastroscopy
Humans
Immunohistochemistry
Laparoscopy
Lymph Node Excision
Lymph Nodes
Microvessels
Neoplasm Metastasis
Stomach Neoplasms
Vascular Endothelial Growth Factor A
Vascular Endothelial Growth Factor A
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