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ESSO 44 | Applying the mesogastrium concept to enhance radical resection in gastric cancer surgery
Domenico D’Ugo, MD, Catholic University of Rome, Rome, Italy, discusses the concept of the mesogastrium and its implications for surgical oncology, highlighting the importance of removing tumors entirely along specific planes to achieve true radicality, or R0 resection, and notes that applying this concept to the stomach is challenging due to the complexity of identifying the embryological plane. Prof. D’Ugo mentions that trials in the East have explored the applicability of this concept, but more evidence is needed in the West to demonstrate its effectiveness. This interview took place at the 44th Congress of the European Society of Surgical Oncology (ESSO 44) in Gothenburg, Sweden.
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Transcript
Conceiving the mesum as a different organism revolutionized the understanding of anatomy some years ago. And now in our ESSO courses, when we teach surgical anatomy to young surgical oncologists, we insist on the fact that removing entirely a tumor in terms of true radicality, that is called R0, should follow some specific plane. Without the trial, this was demonstrated so many years ago by Bill Heald with the introduction of the total mesorectal excision...
Conceiving the mesum as a different organism revolutionized the understanding of anatomy some years ago. And now in our ESSO courses, when we teach surgical anatomy to young surgical oncologists, we insist on the fact that removing entirely a tumor in terms of true radicality, that is called R0, should follow some specific plane. Without the trial, this was demonstrated so many years ago by Bill Heald with the introduction of the total mesorectal excision. Now we know that every single part of the digestive system has a mesome and applying the same idea to different organs should be a way to reach radicality. Is that possible with the stomach where there is no one mechanism? And it’s very complicated to identify this embryological plane. This is a lesson that we have been learning from the East. There are trials that have been conducted on the applicability of this in the East. We are still trying to reach the same demonstration as evidence in the West.
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