{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:29:04Z","timestamp":1786649344320,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Severe kyphosis poses significant challenges to gastric cancer surgery due to anatomical constraints. This case report details a successful laparoscopic distal gastrectomy in a 71-year-old female with advanced pyloric gastric cancer (cT3N1M0) and severe kyphosis from a prior spinal injury. The patient\u2019s spinal deformity, with a 60\u00b0 Cobb angle, restricted abdominal space, rendering open surgery unfeasible. A laparoscopic approach with modified trocar placement and intraoperative adjustments, including low camera positioning and strategic organ retraction, enabled safe resection and Billroth II anastomosis. The procedure was completed without complications, with oral intake resumed on post-operative day 2 and discharge on day 5. This case demonstrates the feasibility of laparoscopic gastrectomy in patients with complex anatomical variations, highlighting the importance of customised surgical planning to achieve minimally invasive outcomes in challenging scenarios.<\/jats:p>","DOI":"10.4103\/jmas.jmas_294_25","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T06:00:46Z","timestamp":1777096846000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic distal gastrectomy gastric cancer in a patient with severe kyphosis: A case report and literature review"],"prefix":"10.4103","author":[{"given":"Hiep Van","family":"Pham","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery, Institute of Digestive Surgery, 108 Military Central Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoai To","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Institute of Digestive Surgery, 108 Military Central Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thang Manh","family":"Tran","sequence":"additional","affiliation":[{"name":"General Surgery Residency Program, College of Health Sciences, VinUniversity, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuong Nguyen Nhu","family":"Pham","sequence":"additional","affiliation":[{"name":"General Surgery Residency Program, College of Health Sciences, VinUniversity, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"R1-20260425","first-page":"1","article-title":"Japanese gastric cancer treatment guidelines 2021 (6th edition)","volume":"26","year":"2023","journal-title":"Gastric 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distal gastrectomy when Billroth I reconstruction is not applicable?A meta-analysis","volume":"98","author":"He","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"R12-20260425","first-page":"CD012998","article-title":"Roux-en-Y versus Billroth-I reconstruction after distal gastrectomy for gastric cancer","volume":"9","author":"Nishizaki","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"R13-20260425","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1001\/jamasurg.2022.2749","article-title":"Laparoscopic versus open distal gastrectomy for locally advanced gastric cancer:5-year outcomes of the KLASS-02 randomized clinical trial","volume":"157","author":"Son","year":"2022","journal-title":"JAMA Surg"}],"container-title":["Journal of Minimal Access 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