Laparoscopy-assisted completion total gastrectomy for gastric cancer in remnant stomach: report of 2 cases.

The completion total gastrectomy is often performed in gastric cancer patients who have previously undergone distal gastrectomy owing to benign or malignant disease. This procedure includes not only removal of the remnant stomach, but also a lymphadenectomy in accordance with upper third gastric cancer. Although laparoscopy-assisted gastrectomy has been approved as one of the treatments of choice for early gastric cancer and its application has also been extend to advanced gastric cancer, only a few studies have reported on laparoscopy-assisted completion total gastrectomy. This is probably because the procedure is technically complicated procedure due to the intra-abdominal adhesion and anatomical changes. Recently, we successfully carried out laparoscopy-assisted completion total gastrectomy in 2 patients diagnosed with advanced gastric cancers in the remnant stomach. Distal gastrectomy was initially performed using laparoscopy-assisted and open procedures, respectively. Furthermore, we conducted the curative operations through a sufficiently extended lymphadenectomy or even through the resection of surrounding organs.