BACKGROUND: The aim of this study was to explore the feasibility and early outcomes of laparoscopy-assisted total gastrectomy with a modified splenic hilar lymphadenectomy for upper- and middle-third stage cT1-2 gastric cancer. METHODS: A total of 97 patients diagnosed with upper- and middle-third stage cT1-T2 gastric cancer were enrolled. Patients were assigned to the laparoscopy-assisted total gastrectomy group (LATG, n = 41) or the open total gastrectomy group (OTG, n = 56). All patients underwent total gastrectomy with modified splenic hilar lymphadenectomy. The operative and postoperative measures, number of retrieved lymph nodes (LNs), and complications were compared between the two groups. RESULTS: The mean number of dissected LNs was not significantly different between the two groups: 23.1 ± 8.0 in the LATG group versus 24.2 ± 7.5 in the OTG group. Compared with the OTG group, the LATG group had less operative blood loss [104.2 ± 42.9 vs. 355.6 ± 51.3 ml (p < 0.0001)], shorter time to out-of-bed activities [14.4 ± 3.2 vs. 16.5 ± 1.2 h (p < 0.0001)], shorter time to first flatus [72.2 ± 16.2 vs. 78.4 ± 8.6 h (p = 0.017)], earlier resumption of soft diet [52.8 ± 21.6 vs. 74.2 ± 12.2 h (p < 0.0001)], and shorter postoperative hospital stay [9.7 ± 2.2 vs. 13.6 ± 3.6 days (p < 0.0001)]. However, LATG had a slightly longer operating time than OTG [235.7 ± 38.5 vs. 211.5 ± 33.2 min (p = 0.001)]. The operative complications rates for the LATG and OTG groups were not significantly different: 4.9 versus 5.4 %. CONCLUSION: For upper- and middle-third stage cT1-2 gastric cancer, a limited splenic hilar lymphadenectomy strategy seems to be safe and feasible, particularly for the number of retrieved LNs. However, this technique is not suitable for cT3 disease.
BACKGROUND: The aim of this study was to explore the feasibility and early outcomes of laparoscopy-assisted total gastrectomy with a modified splenic hilar lymphadenectomy for upper- and middle-third stage cT1-2gastric cancer. METHODS: A total of 97 patients diagnosed with upper- and middle-third stage cT1-T2 gastric cancer were enrolled. Patients were assigned to the laparoscopy-assisted total gastrectomy group (LATG, n = 41) or the open total gastrectomy group (OTG, n = 56). All patients underwent total gastrectomy with modified splenic hilar lymphadenectomy. The operative and postoperative measures, number of retrieved lymph nodes (LNs), and complications were compared between the two groups. RESULTS: The mean number of dissected LNs was not significantly different between the two groups: 23.1 ± 8.0 in the LATG group versus 24.2 ± 7.5 in the OTG group. Compared with the OTG group, the LATG group had less operative blood loss [104.2 ± 42.9 vs. 355.6 ± 51.3 ml (p < 0.0001)], shorter time to out-of-bed activities [14.4 ± 3.2 vs. 16.5 ± 1.2 h (p < 0.0001)], shorter time to first flatus [72.2 ± 16.2 vs. 78.4 ± 8.6 h (p = 0.017)], earlier resumption of soft diet [52.8 ± 21.6 vs. 74.2 ± 12.2 h (p < 0.0001)], and shorter postoperative hospital stay [9.7 ± 2.2 vs. 13.6 ± 3.6 days (p < 0.0001)]. However, LATG had a slightly longer operating time than OTG [235.7 ± 38.5 vs. 211.5 ± 33.2 min (p = 0.001)]. The operative complications rates for the LATG and OTG groups were not significantly different: 4.9 versus 5.4 %. CONCLUSION: For upper- and middle-third stage cT1-2gastric cancer, a limited splenic hilar lymphadenectomy strategy seems to be safe and feasible, particularly for the number of retrieved LNs. However, this technique is not suitable for cT3 disease.
Authors: Jiang Long Huang; Hong Bo Wei; Zong Heng Zheng; Bo Wei; Tu Feng Chen; Yong Huang; Wei Ping Guo; Baoguang Hu Journal: Dig Surg Date: 2010-07-31 Impact factor: 2.588
Authors: Gaya Spolverato; Yuhree Kim; Aslam Ejaz; Vicente Valero; Malcolm H Squires; George Poultsides; Ryan C Fields; Mark Bloomston; Sharon M Weber; Alexandra W Acher; Konstantinos Votanopoulos; Carl Schmidt; Clifford S Cho; Shishir K Maithel; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2014-06-10 Impact factor: 3.452