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

Background: To explore the feasibility of laparoscopic spleen-preserving No.10 lymph node dissection in aleft-sided approach for advanced proximal gastric cancer. Methods: The clinical data of 32 patients with advanced proximal gastric cancer who underwentlaparoscopic spleen-preserving No.10 lymph node dissection from June 2010 to December2011 were analyzed. Results: Laparoscopic spleen-preserving No.10 lymph node dissection using a left-sided approach wassuccessfully performed for all patients without open conversion. The mean operation timewas 206.4+/-54.3 minutes, mean intraoperative blood loss was 68.2+/-34.1 ml, mean number ofNo.10 lymph nodes dissected was 2.8+/-2.1, mean number of positive No.10 lymph nodes was0.6+/-1.2, and the incidence of No.10 lymph node metastasis was 11.6 %. The meanpostoperative 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 wereanatomically classified and divided into three types: 4 patients had a single lobar vessel, 22had two lobar vessels and 6 had three lobar vessels. . Conclusions: Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastriccancer using a left-sided approach is technically feasible. It simplifies the complicatedsurgical procedure of No. 10 lymph node dissection and leads to the popularization andpromotion of this technique.

via World Journal of Surgical Oncology