Technical innovations

World Journal of Surgical Oncology

, 10:241

Open Access This content is freely available online to anyone, anywhere at any time.

Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer in left approach: a new operation procedure

  • Wang Jia-BinAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital
  • , Huang Chang-MingAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital Email author 
  • , Zheng Chao-HuiAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital
  • , Li PingAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital
  • , Xie Jian-WeiAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital
  • , Lin Jian-XianAffiliated withDepartment of Gastric Surgery, Fujian Medical University Union Hospital

Abstract

Background

To explore the feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection in a left-sided approach for advanced proximal gastric cancer.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Stomach neoplasms Spleen-preservation Laparoscopy Lymph node dissection