Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer in left approach: a new operation procedure
To explore the feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection in a left-sided approach for advanced proximal gastric cancer.
The clinical data of 32 patients with advanced proximal gastric cancer who underwent laparoscopic spleen-preserving No. 10 lymph node dissection from June 2010 to December 2011 were analyzed.
Laparoscopic spleen-preserving No. 10 lymph node dissection using a left-sided approach was successfully performed for all patients without open conversion. The mean operation time was 206.4±54.3 minutes, mean intraoperative blood loss was 68.2±34.1 ml, mean number of No. 10 lymph nodes dissected was 2.8±2.1, mean number of positive No. 10 lymph nodes was 0.6±1.2, and the incidence of No. 10 lymph node metastasis was 11.6%. The mean postoperative hospital stay was 11.3±1.5 days. The postoperative morbidity rate was 9.4%, and there was no postoperative death. Splenic lobar vessels of all 32 patients were anatomically classified and divided into three types: 4 patients had a single lobar vessel, 22 had two lobar vessels and 6 had three lobar vessels.
Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer using a left-sided approach is technically feasible. It simplifies the complicated surgical procedure of No. 10 lymph node dissection and leads to the popularization and promotion of this technique.
- Monig, SP, Collet, PH, Baldus, SE, Schmackpfeffer, K, Schröder, W, Thiele, J, Dienes, HP, Hölscher, AH (2001) Splenectomy in proximal gastric cancer: frequency of lymph node metastasis to the splenic hilus. J SurgOncol 76: pp. 89-92
- Ikeguchi, M, Kaibara, N (2004) Lymph node metastasis at the splenic hilum in proximal gastric cancer. Am Surg 70: pp. 645-648
- Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14: pp. 113-123 CrossRef
- Brunschwig, A (1948) Pancreato-total gastrectomyandsplenectomy for advanced carcinoma of the stomach. Cancer 1: pp. 427-430 CrossRef
- Okajima, K, Isozaki, H (1995) Splenectomy for treatment of gastric cancer: Japanese experience. World J Surg 19: pp. 537-540 CrossRef
- Maruyama, K, Sasako, M, Kinoshita, T, Sano, T, Katai, H, Okajima, K (1995) Pancreas-preserving total gastrectomy for proximal gastric cancer. World J Surg 19: pp. 532-536 CrossRef
- Kitamura, K, Nishida, S, Ichikawa, D, Taniguchi, H, Hagiwara, A, Yamaguchi, T, Sawai, K (1999) No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. Br J Surg 86: pp. 119-122 CrossRef
- Otsuji, E, Yamaguchi, T, Sawai, K, Okamoto, K, Takahashi, T (1999) Total gastrectomy with simultaneous pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma. Br J Cancer 79: pp. 1789-1793 CrossRef
- Kwon, SJ (1997) Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group. World J Surg 21: pp. 837-844 CrossRef
- Yu, W, Choi, GS, Chung, HY (2006) Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. Br J Surg 93: pp. 559-563 CrossRef
- Sano, T, Yamamoto, S, Sasako, M (2002) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma: Japan clinical oncology group study JCOG 0110-MF. Jpn J ClinOncol 32: pp. 363-364 CrossRef
- Lee, JH, Han, HS, Lee, JH (2005) A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. SurgEndosc 19: pp. 168-173
- Hayashi, H, Ochiai, T, Shimada, H, Gunji, Y (2005) Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. SurgEndosc 19: pp. 1172-1176
- Kitano, S, Shiraishi, N, Fujii, K, Yasuda, K, Inomata, M, Adachi, Y (2002) A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery 131: pp. S306-S311 CrossRef
- Yasuda, K, Shiraishi, N, Etoh, T, Shiromizu, A, Inomata, M, Kitano, S (2007) Long-term quality of life after laparoscopy-assisted distal gastrectomy for gastric cancer. SurgEndosc 21: pp. 2150-2153
- Hyung, WJ, Lim, JS, Song, J, Choi, SH, Noh, SH (2008) Laparoscopic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. J Am CollSurg 207: pp. e6-e11 CrossRef
- Okabe, H, Obama, K, Kan, T, Tanaka, E, Itami, A, Sakai, Y (2010) Medial approach for laparoscopic total gastrectomy with splenic lymph node dissection. J Am CollSurg 211: pp. e1-e6 CrossRef
- Redmond, HP, Redmond, JM, Rooney, BP, Duignan, JP, Bouchier-Hayes, DJ (1989) Surgical anatomy of the human spleen. Br J Surg 76: pp. 198-201 CrossRef
- Kitano, S, Iso, Y, Moriyama, M, Sugimachi, K (1994) Laparoscopy assisted Billroth I gastrectomy. SurgLaparoscEndosc 4: pp. 146-148
- Goh, PM, Khan, AZ, So, JB, Lomanto, D, Cheah, WK, Muthiah, R, Gandhi, A (2001) Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. SurgLaparoscEndoscPercutan Tech 11: pp. 83-87
- Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer in left approach: a new operation procedure
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
World Journal of Surgical Oncology
- Online Date
- November 2012
- Online ISSN
- BioMed Central
- Additional Links
- Stomach neoplasms
- Lymph node dissection