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In the final part of this three-part series on ways to treat stomach cancer in Japan, we will take a look at the latest stomach cancer treatments that are being conducted in Japan.
Tumors that form beneath the stomach’s mucosa (innermost layer) are collectively known as submucosal tumors. These tumors can be either benign or malignant. One type of malignant submucosal tumor, for which surgery is recommended, is the gastrointestinal stromal tumor (GIST).
Unlike stomach cancer, GISTs rarely metastasize to lymph nodes. Therefore, the tumor is primarily removed with local excision—a procedure that involves cutting only the immediate area around the tumor.
Laparoscopy is actively offered to GIST patients to treat stomach cancer in Japan at the Cancer Institute Hospital, as it yields a high success rate and is a relatively gentle procedure that reduces the physical trauma experienced by the patient. Further adjustments are made to tailor the procedure to the location and size of the tumor.
Laparoscopic endoscopic cooperative surgery (LECS)
There is a surgical procedure developed by Dr. Naoki Hiki—Director of the Gastric Surgery Department at the Cancer Institute Hospital—that involves the simultaneous use of endoscopy and laparoscopy to examine and remove tumors in the stomach. He has given it the English name, laparoscopic endoscopic cooperative surgery, or LECS.
A GIST tends to expand both inwards and outwards. This procedure allows the surgeon to examine both the exterior and interior of the stomach at the same time to accurately determine the size of the tumor before cutting into the stomach. As a result, the patient loses a minimal amount of stomach tissue, experiences minimal deformation in their stomach, and maintains almost all of their gastric functions.
As its names suggests, LECS is essentially a collaboration between an endoscopic doctor and a surgeon. It requires the former’s ability to determine the extent of the cancer’s growth and dissect the mucosa, and the latter’s ability to complete the dissection of the stomach wall and sew the remaining parts of the stomach together. It is an effective, minimally invasive treatment for GISTs that the Cancer Institute Hospital plans to also introduce to patients with early stomach cancer.