Complete Mesogastric Excision With D2 Lympadenectomy for Gastric Cancer:

The curative treatment of gastrointestinal tumors is surgery referring to an en block resection of the primary tumor along with its lymphovascular drainage.Unfortunately, despite of these radical resections, published literature shows that recurrences occur in up to 38% of patients in 5 years. Morover, these rates may reach to 60% in patients with locally advanced tumor following radical surgery. However, this mesentery-based surgery is harder to apply in gastric cancer due to differences in embriyological development. In our prospective study and a review of the literature, following the descripiton of mesogastrium concept, we aimed to search and analyse former techniques and viewpoints about mesogastric excision by different surgical approaches from various countries. Later, we aimed to show our technique of mesogastrectomy, compared our short term results with limited publications from the literature.

Inclusion criteria

• Patients with histopathologically confirmed gastric adenocancer without evidence of distal metastasis and resectable tumors which have been treated with open total gastrectomy.

Exclusion criteria

• Patients with prior upper gastrointestinal system surgery
• Patients with neoadjuvant therapy
• Patients with peripheral organ involvement and/or distant metastasis
• Patients who underwent subtotal gastrectomy
• Patients who underwent laparoscopic and robotic operations