Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2012

Open Access 01-12-2012 | Technical innovations

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

Authors: Wang Jia-Bin, Huang Chang-Ming, Zheng Chao-Hui, Li Ping, Xie Jian-Wei, Lin Jian-Xian

Published in: World Journal of Surgical Oncology | Issue 1/2012

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Monig SP, Collet PH, Baldus SE, Schmackpfeffer K, Schröder W, Thiele J, Dienes HP, Hölscher AH: Splenectomy in proximal gastric cancer: frequency of lymph node metastasis to the splenic hilus. J SurgOncol. 2001, 76: 89-92. Monig SP, Collet PH, Baldus SE, Schmackpfeffer K, Schröder W, Thiele J, Dienes HP, Hölscher AH: Splenectomy in proximal gastric cancer: frequency of lymph node metastasis to the splenic hilus. J SurgOncol. 2001, 76: 89-92.
2.
go back to reference Ikeguchi M, Kaibara N: Lymph node metastasis at the splenic hilum in proximal gastric cancer. Am Surg. 2004, 70: 645-648.PubMed Ikeguchi M, Kaibara N: Lymph node metastasis at the splenic hilum in proximal gastric cancer. Am Surg. 2004, 70: 645-648.PubMed
3.
go back to reference Japanese Gastric Cancer Association: Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011, 14: 113-123.CrossRef Japanese Gastric Cancer Association: Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011, 14: 113-123.CrossRef
4.
go back to reference Brunschwig A: Pancreato-total gastrectomyandsplenectomy for advanced carcinoma of the stomach. Cancer. 1948, 1: 427-430. 10.1002/1097-0142(194809)1:3<427::AID-CNCR2820010308>3.0.CO;2-G.CrossRefPubMed Brunschwig A: Pancreato-total gastrectomyandsplenectomy for advanced carcinoma of the stomach. Cancer. 1948, 1: 427-430. 10.1002/1097-0142(194809)1:3<427::AID-CNCR2820010308>3.0.CO;2-G.CrossRefPubMed
5.
go back to reference Okajima K, Isozaki H: Splenectomy for treatment of gastric cancer: Japanese experience. World J Surg. 1995, 19: 537-540. 10.1007/BF00294715.CrossRefPubMed Okajima K, Isozaki H: Splenectomy for treatment of gastric cancer: Japanese experience. World J Surg. 1995, 19: 537-540. 10.1007/BF00294715.CrossRefPubMed
6.
go back to reference Maruyama K, Sasako M, Kinoshita T, Sano T, Katai H, Okajima K: Pancreas-preserving total gastrectomy for proximal gastric cancer. World J Surg. 1995, 19: 532-536. 10.1007/BF00294714.CrossRefPubMed Maruyama K, Sasako M, Kinoshita T, Sano T, Katai H, Okajima K: Pancreas-preserving total gastrectomy for proximal gastric cancer. World J Surg. 1995, 19: 532-536. 10.1007/BF00294714.CrossRefPubMed
7.
go back to reference Kitamura K, Nishida S, Ichikawa D, Taniguchi H, Hagiwara A, Yamaguchi T, Sawai K: No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. Br J Surg. 1999, 86: 119-122. 10.1046/j.1365-2168.1999.00967.x.CrossRefPubMed Kitamura K, Nishida S, Ichikawa D, Taniguchi H, Hagiwara A, Yamaguchi T, Sawai K: No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. Br J Surg. 1999, 86: 119-122. 10.1046/j.1365-2168.1999.00967.x.CrossRefPubMed
8.
go back to reference Otsuji E, Yamaguchi T, Sawai K, Okamoto K, Takahashi T: Total gastrectomy with simultaneous pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma. Br J Cancer. 1999, 79: 1789-1793. 10.1038/sj.bjc.6690285.PubMedCentralCrossRefPubMed Otsuji E, Yamaguchi T, Sawai K, Okamoto K, Takahashi T: Total gastrectomy with simultaneous pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma. Br J Cancer. 1999, 79: 1789-1793. 10.1038/sj.bjc.6690285.PubMedCentralCrossRefPubMed
9.
go back to reference Kwon SJ: Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group. World J Surg. 1997, 21: 837-844. 10.1007/s002689900314.CrossRefPubMed Kwon SJ: Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group. World J Surg. 1997, 21: 837-844. 10.1007/s002689900314.CrossRefPubMed
10.
go back to reference Yu W, Choi GS, Chung HY: Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. Br J Surg. 2006, 93: 559-563. 10.1002/bjs.5353.CrossRefPubMed Yu W, Choi GS, Chung HY: Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancer. Br J Surg. 2006, 93: 559-563. 10.1002/bjs.5353.CrossRefPubMed
11.
go back to reference Sano T, Yamamoto S, Sasako M: Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma: Japan clinical oncology group study JCOG 0110-MF. Jpn J ClinOncol. 2002, 32: 363-364. Sano T, Yamamoto S, Sasako M: Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma: Japan clinical oncology group study JCOG 0110-MF. Jpn J ClinOncol. 2002, 32: 363-364.
12.
go back to reference Lee JH, Han HS, Lee JH: A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. SurgEndosc. 2005, 19: 168-173. Lee JH, Han HS, Lee JH: A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. SurgEndosc. 2005, 19: 168-173.
13.
go back to reference Hayashi H, Ochiai T, Shimada H, Gunji Y: Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. SurgEndosc. 2005, 19: 1172-1176. Hayashi H, Ochiai T, Shimada H, Gunji Y: Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. SurgEndosc. 2005, 19: 1172-1176.
14.
go back to reference Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y: A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery. 2002, 131: S306-S311. 10.1067/msy.2002.120115.CrossRefPubMed Kitano S, Shiraishi N, Fujii K, Yasuda K, Inomata M, Adachi Y: A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. Surgery. 2002, 131: S306-S311. 10.1067/msy.2002.120115.CrossRefPubMed
15.
go back to reference Yasuda K, Shiraishi N, Etoh T, Shiromizu A, Inomata M, Kitano S: Long-term quality of life after laparoscopy-assisted distal gastrectomy for gastric cancer. SurgEndosc. 2007, 21: 2150-2153. Yasuda K, Shiraishi N, Etoh T, Shiromizu A, Inomata M, Kitano S: Long-term quality of life after laparoscopy-assisted distal gastrectomy for gastric cancer. SurgEndosc. 2007, 21: 2150-2153.
16.
go back to reference Hyung WJ, Lim JS, Song J, Choi SH, Noh SH: Laparoscopic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. J Am CollSurg. 2008, 207: e6-e11. Hyung WJ, Lim JS, Song J, Choi SH, Noh SH: Laparoscopic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. J Am CollSurg. 2008, 207: e6-e11.
17.
go back to reference Okabe H, Obama K, Kan T, Tanaka E, Itami A, Sakai Y: Medial approach for laparoscopic total gastrectomy with splenic lymph node dissection. J Am CollSurg. 2010, 211: e1-e6. Okabe H, Obama K, Kan T, Tanaka E, Itami A, Sakai Y: Medial approach for laparoscopic total gastrectomy with splenic lymph node dissection. J Am CollSurg. 2010, 211: e1-e6.
18.
go back to reference Redmond HP, Redmond JM, Rooney BP, Duignan JP, Bouchier-Hayes DJ: Surgical anatomy of the human spleen. Br J Surg. 1989, 76: 198-201. 10.1002/bjs.1800760230.CrossRefPubMed Redmond HP, Redmond JM, Rooney BP, Duignan JP, Bouchier-Hayes DJ: Surgical anatomy of the human spleen. Br J Surg. 1989, 76: 198-201. 10.1002/bjs.1800760230.CrossRefPubMed
19.
go back to reference Kitano S, Iso Y, Moriyama M, Sugimachi K: Laparoscopy assisted Billroth I gastrectomy. SurgLaparoscEndosc. 1994, 4: 146-148. Kitano S, Iso Y, Moriyama M, Sugimachi K: Laparoscopy assisted Billroth I gastrectomy. SurgLaparoscEndosc. 1994, 4: 146-148.
20.
go back to reference Goh PM, Khan AZ, So JB, Lomanto D, Cheah WK, Muthiah R, Gandhi A: Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. SurgLaparoscEndoscPercutan Tech. 2001, 11: 83-87. Goh PM, Khan AZ, So JB, Lomanto D, Cheah WK, Muthiah R, Gandhi A: Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. SurgLaparoscEndoscPercutan Tech. 2001, 11: 83-87.
Metadata
Title
Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer in left approach: a new operation procedure
Authors
Wang Jia-Bin
Huang Chang-Ming
Zheng Chao-Hui
Li Ping
Xie Jian-Wei
Lin Jian-Xian
Publication date
01-12-2012
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2012
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-10-241

Other articles of this Issue 1/2012

World Journal of Surgical Oncology 1/2012 Go to the issue