Totally laparoscopic total gastrectomy with D2 lymphadenectomy and esophagojejunal Roux-en-Y anastomosis

A case of a 67-year-old female patient with gastric body carcinoma was reported in this article. This patient underwent upper abdominal dull pain and discomfort for over 2 months repeatedly, and then hospitalized on 2015-03-22 for treatment. She underwent gastroscopy with biopsies. The gastroscopy result shown an ulcer about 2.0×1.5 cm² was located in the greater curvature of the gastric body. Pathological biopsy confirmed that it was gastric adenocarcinoma. Upper abdomen enhanced CT scan: uneven incrassation in stomach wall locating in paries posterior of gastric body, light reinforcement after enhancing, and no obvious swelling of perigastric and celiac lymph nodes. The above examinations obviously shown that the preoperative clinical stage is cT3N0M0. Preoperative evaluation of the patient allowed her to undergo surgical treatment and advanced gastric cancer. Based on the NCCN guidelines, D2 lymphadenectomy was required. Preoperative examinations shown that there were no definite contraindications for surgery. Therefore, distal gastrectomy with D2 lymphadenectomy was adopted. Lymph nodes of group 1, 2, 3, 4sb, 5, 6, 7, 8a, 9, 10, 11P, 11d, 12a and 14v were dissected.