Abstract
Background
D2 lymphadenectomy including No.10 lymph nodes (LNs) is the standard procedure for
treating advanced gastric cancer (AGC) via total gastrectomy. However, there was no
research focusing on the posterior LN dissection along the splenic vessels (No.10p
LNs). This study is performed to assess the effect of dissecting No.10p LNs.
Methods
We analyzed 404 consecutive gastric cancer patients who underwent laparoscopic total
gastrectomy (LTG) with D2 lymphadenectomy. There were 68 patients with No.10p LN dissection
(No.10p group), and 336 patients without No.10p LN dissection (nNo.10p group). The
surgical outcomes are compared.
Results
No.10p LN dissection was preferentially performed in patients who were younger and
had a lower BMI, concentrated and single-branched type of splenic artery, and pancreatic
tail near the lower pole of the spleen. The time for No.10 LN dissection and the number
of No.10 LNs were greater in the No.10p group than in the nNo.10p group. There was
no No.10p LNs metastasis, and the numbers of positive No.10 LNs were similar between
the two groups. The morbidity and mortality rates of the No.10p group were comparable
to those of the nNo.10p group. The overall survival (OS) rates of the two groups were
not significantly different (P > 0.05).
Conclusions
Although No.10p LN dissection might retrieve more No.10 LNs, operation times were
longer, and the number of positive No.10 LNs and the OS rate were not improved. It
might be no necessary to dissect No.10p LNs during total gastrectomy with D2 lymphadenectomy
for AGC.
Keywords
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Article info
Publication history
Published online: September 18, 2017
Accepted:
September 6,
2017
Footnotes
☆Supported by National key clinical specialty discipline construction program of China (No. [2012]649). Scientific and technological innovation joint capital projects of Fujian Province, China (No. 2016Y9031). The youth research project of Fujian Provincial Health and Family Planning Commission (2014-1-48).
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
