Complete Mesogastric Excisions Involving Anatomically Based Concepts and Embryological-Based Surgeries: Current Knowledge and Future Challenges

Sergii Girnyi, Marcin Ekman, Luigi Marano, Franco Roviello, Karol Połom, Sergii Girnyi, Marcin Ekman, Luigi Marano, Franco Roviello, Karol Połom

Abstract

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept.

Keywords: anatomical dissection; embryological planes; gastric cancer; mesogastrium.

Conflict of interest statement

The authors declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Table Model for complete mesogastric excision.

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