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  <front>
    <article-meta>
      <title-group>
        <article-title>Laparoscopic-assisted total gastrectomy with D2 lymph node dissection: a case of 12-year-old child with advanced gastric cancer</article-title>
      </title-group>
      <contrib-group content-type="author">
        <contrib id="person-4d7f9f304503cbd506c3e04e4f957cde" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Tu</surname>
            <given-names>Ru-Hong</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-1" />
        </contrib>
        <contrib id="person-33430dd6ecbbce9f727da7d4e82e63a9" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Lin</surname>
            <given-names>Jian-Xian</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-2" />
        </contrib>
        <contrib id="person-a6f6ab4ff392b4646816cada9b557805" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Li</surname>
            <given-names>Ping</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-3" />
        </contrib>
        <contrib id="person-1efb93653074175fd0ce47de63d3efd8" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Xie</surname>
            <given-names>Jian-Wei</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-4" />
        </contrib>
        <contrib id="person-72c3c29b6aff6fa4e5d26654f5edaec5" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Wang</surname>
            <given-names>Jia-Bin</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-5" />
        </contrib>
        <contrib id="person-4820a2be8c49451da18179806f79df70" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Lu</surname>
            <given-names>Jun</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-6" />
        </contrib>
        <contrib id="person-1105211106233dacf96bae36d0d62916" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Chen</surname>
            <given-names>Qi-Yue</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-7" />
        </contrib>
        <contrib id="person-8cf011885606f43c92e6a6e7c518b0b5" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Cao</surname>
            <given-names>Long-Long</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-8" />
        </contrib>
        <contrib id="person-49f46da98174ddb8ef945992c1ee7593" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Lin</surname>
            <given-names>Mi</given-names>
          </name>
          <email>jx.lin@journalofgastricsurgery.com</email>
          <xref ref-type="aff" rid="aff-9" />
        </contrib>
        <contrib id="person-42f9ffdeab573a9fc0c297888761d613" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Zheng</surname>
            <given-names>Chao-Hui</given-names>
          </name>
          <email>wwkzch@163.com</email>
          <xref ref-type="aff" rid="aff-10" />
        </contrib>
        <contrib id="person-5036cceaf4453363a3a1613d52b058ad" contrib-type="person" equal-contrib="no" corresp="no" deceased="no">
          <name>
            <surname>Huang</surname>
            <given-names>Chang-Ming</given-names>
          </name>
          <email>hcmlr2002@163.com</email>
          <xref ref-type="aff" rid="aff-11" />
        </contrib>
      </contrib-group>
      <aff id="aff-1">
        <country>China</country>
      </aff>
      <aff id="aff-2">
        <country>China</country>
      </aff>
      <aff id="aff-3">
        <country>China</country>
      </aff>
      <aff id="aff-4">
        <country>China</country>
      </aff>
      <aff id="aff-5">
        <country>China</country>
      </aff>
      <aff id="aff-6">
        <country>China</country>
      </aff>
      <aff id="aff-7">
        <country>China</country>
      </aff>
      <aff id="aff-8">
        <country>China</country>
      </aff>
      <aff id="aff-9">
        <country>China</country>
      </aff>
      <aff id="aff-10">
        <country>China</country>
      </aff>
      <aff id="aff-11">
        <country>China</country>
      </aff>
      <history>
        <date date-type="received" iso-8601-date="2020-02-05">
          <day>05</day>
          <month>02</month>
          <year>2020</year>
        </date>
      </history>
      <abstract>
        <p id="paragraph-406851fb1be668b8c430186758970e00">The video shows the operation of laparoscopic-assisted total gastrectomy with D2 lymph node dissection for a 12-year-old child with advanced gastric cancer.</p>
      </abstract>
    </article-meta>
  </front>
  <body id="body">
    <p id="_paragraph-12">
      <bold id="_bold-1">To Cite</bold>
    </p>
    <p id="_paragraph-13">Tu R-H, Lin J-X, Ping L, Xie J-W,Wang J-B, Lu J, Chen Q-Y, Cao L-L, Lin M, Zheng C-H, Huang C-M, Laparoscopic-assisted total gastrectomy with D2 lymph node dissection: a case of 12-year-old child with advanced gastric cancer. J Gastric Surg 2020; 2(1): 24-</p>
    <p id="_paragraph-14">25</p>
    <p id="_paragraph-15">
      <bold id="_bold-2">Publication history</bold>
    </p>
    <p id="_paragraph-16">Received: February 5, 2020</p>
    <p id="_paragraph-17">Revised: February ,2020</p>
    <p id="_paragraph-18">Accepted: February 20, 2020</p>
    <p id="_paragraph-19">Article impress: February 28, 2020</p>
    <p id="_paragraph-20">Published on line: March 15, 2020</p>
    <p id="_paragraph-21">
      <bold id="_bold-3">*Correspondence to</bold>
    </p>
    <p id="_paragraph-22">Chang-Ming Huang</p>
    <p id="_paragraph-23">Department of Gastric Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou 350001, China.<ext-link id="_external-link-1" ext-link-type="uri" xlink:href="mailto:cmlr2002@163.com"> cmlr2002@163.com</ext-link></p>
    <p id="_paragraph-24">Telephone: +86-591-83363366</p>
    <p id="_paragraph-25">Fax: +86-591-83320319.</p>
    <p id="_paragraph-26">Chao-Hui Zheng</p>
    <p id="_paragraph-27">Department of Gastric Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou 350001, China.<ext-link id="_external-link-2" ext-link-type="uri" xlink:href="mailto:wwkzch@163.com"> wwkzch@163.com</ext-link></p>
    <p id="_paragraph-28">Telephone: +86-591-83363366</p>
    <p id="_paragraph-29">Fax: +86-591-83320319.</p>
    <sec id="sec-1">
      <title>
        <bold id="_bold-4">Keywords:</bold>
      </title>
      <p id="_paragraph-30">gastric cancer, laparoscopic gastrectomy, children.</p>
    </sec>
    <sec id="sec-2">
      <title>
        <bold id="_bold-5">Background:</bold>
      </title>
      <p id="_paragraph-31">Primary gastric adenocarcinoma is extremely rare in children, with advanced stage, poorer differentiation, lower radical resection rate and poorer prognosis [1-4]. Surgery is the most efficient treatment for gastric cancer in children. However, there is no report on laparoscopic gastrectomy (LG) for gastric cancer in children. Here, we report a laparoscopy-assisted total gastrectomy (LATG) with D2 lymph node (LN) dissection performed on a 12-year-old child with advanced gastric cancer.</p>
    </sec>
    <sec id="sec-3">
      <title><bold id="_bold-6">Methods</bold>:</title>
      <p id="_paragraph-32">A 12-year-old girl admitted our institution because of hematemesis and melena. Preoperative endoscopy and biopsy showed a signet-ring cell carcinoma in the body of stomach. Both ultrasonography and computerized tomography showed no distant metastasis. She was submitted to a LATG with D2 LN dissection in December 21, 2011.</p>
    </sec>
    <sec id="sec-4">
      <title>
        <bold id="_bold-7">Results:</bold>
      </title>
      <p id="_paragraph-33">The total operation time was 180 min, and the blood loss was 20 ml. We also find two anatomic variants of perigastric vessels: absence of the coronary vein and the common hepatic artery ran behind the portal vein. The postoperative pathological was pT4aN0M0, Stage IIB, and the number of dissection LNs was 56. The postoperative course was smooth with the child resuming diet by postoperative day (POD) 4. She discharged on POD 9. No adjuvant chemotherapy post- operation, until Dec. 2019, she has disease-free survival for 96 months.</p>
    </sec>
    <sec id="sec-5">
      <title>
        <bold id="_bold-8">Conclusions:</bold>
      </title>
      <p id="_paragraph-34">LG may be benefit for children gastric cancer with the advantages of minimally invasive. However, because of small abdominal space, smaller vessels, and more fragile tissue, this technique still has some difficulties and should be performed by experienced surgeons.</p>
      <sec id="sec-5_1">
        <title>
          <bold id="_bold-9">
            <italic id="_italic-1">Acknowledgements</italic>
          </bold>
        </title>
        <p id="_paragraph-35">The authors thank Fujian Medical University Union Hospital for her management of our gastric cancer patient database.</p>
      </sec>
      <sec id="sec-5_2">
        <title>
          <bold id="_bold-10">
            <italic id="_italic-2">Contributors</italic>
          </bold>
        </title>
        <p id="_paragraph-36">All authors were equally involved in this article.</p>
      </sec>
      <sec id="sec-5_3">
        <title>
          <bold id="_bold-11">
            <italic id="_italic-3">Funding</italic>
          </bold>
        </title>
        <p id="_paragraph-37">None.</p>
      </sec>
      <sec id="sec-5_4">
        <title>
          <bold id="_bold-12">
            <italic id="_italic-4">Competing interests</italic>
          </bold>
        </title>
        <p id="_paragraph-38">No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.</p>
      </sec>
      <sec id="sec-5_5">
        <title>
          <bold id="_bold-13">
            <italic id="_italic-5">Availability of data and materials</italic>
          </bold>
        </title>
        <p id="_paragraph-39">The video associated whit this article can be found, in the on-line version, at:</p>
        <p id="_paragraph-40">https://<ext-link id="_external-link-3" ext-link-type="uri" xlink:href="http://www.journalofgastricsurgery.com/index.php/">www.journalofgastricsurgery.com/index.php/</ext-link></p>
        <p id="_paragraph-41">JGS/article/view/14</p>
      </sec>
      <sec id="sec-5_6">
        <title>
          <bold id="_bold-14">
            <italic id="_italic-6">Ethics approval</italic>
          </bold>
        </title>
        <p id="_paragraph-42">Not applicable</p>
      </sec>
      <sec id="sec-5_7">
        <title>
          <bold id="_bold-15">
            <italic id="_italic-7">Provenance and peer review</italic>
          </bold>
        </title>
        <p id="_paragraph-43">Not commissioned; externally peer reviewed.</p>
      </sec>
      <sec id="sec-5_8">
        <title>
          <bold id="_bold-16">
            <italic id="_italic-8">Open access</italic>
          </bold>
        </title>
        <p id="_paragraph-44">This is an Open Access article distributed in accordance with the Creative Commons Attribution Non- Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/</p>
      </sec>
    </sec>
  </body>
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</article>