Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method
Objective To investigate the feasibility and safety of laparoscopic spleen-preserving splenic hilum lymph nodes (LNs) dissection for advanced proximal gastric cancer using an omnibearing method. Methods Between August 2013 and December 2014, 16 patients with advanced proximal gastric cancer treated...
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| Veröffentlicht in: | Surgical endoscopy 2016-05, Vol.30 (5), p.2030-2035 |
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| creator | Wang, Wei Liu, Zhiwei Xiong, Wenjun Zheng, Yansheng Luo, Lijie Diao, Dechang Wan, Jin |
| description | Objective
To investigate the feasibility and safety of laparoscopic spleen-preserving splenic hilum lymph nodes (LNs) dissection for advanced proximal gastric cancer using an omnibearing method.
Methods
Between August 2013 and December 2014, 16 patients with advanced proximal gastric cancer treated in Guangdong Province Hospital of Chinese Medicine, were enrolled and subsequently underwent laparoscopic radical total gastrectomy (TG) with spleen-preserving splenic hilum LNs dissection. During dissecting Nos. 10 and 11 LNs, we divided them into two parts, namely LNs anterosuperior and posterior to the splenic vessel. The clinicopathological characteristics, intraoperative outcomes and postoperative courses were retrospectively collected and analyzed in the study.
Results
Laparoscopic surgery was successfully completed in all 16 patients without conversion to open surgery, and no perioperative death occurred. The mean operating time was 328.75 ± 46.96 min, and the mean estimated blood loss was 135.63 ± 62.07 ml. One patient experienced intraoperative bleeding due to the splenic vein injury which was successfully handled with laparoscopic vessel suturing, and one postoperative pulmonary infection was recorded. The mean time to first flatus was 3.56 ± 1.03 days with a mean 9.63 ± 1.50 days of postoperative hospital stay. The mean number of retrieved LNs was 28.31 ± 5.99, in which LNs anterosuperior to splenic artery was 2.88 ± 2.66 and LNs posterior was 1.38 ± 1.75.
Conclusion
Laparoscopic TG with spleen-preserving splenic hilum LNs dissection using an omnibearing method for advanced proximal gastric cancer was safe and technically feasible in experienced hands. Further studies in terms of its clinical significance are needed. |
| doi_str_mv | 10.1007/s00464-015-4438-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1785733644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1785733644</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-285946bc2c30b23af61eaded1d6489dae2d3101deaf573edc7f9b09559706a83</originalsourceid><addsrcrecordid>eNp1kUuLFDEUhYM4OG2PP8CNBNzMJppXPeJOhvEBA256H1LJrekMqaRMqoRe-dcnZY8igqsLud85N5yD0GtG3zFKu_eFUtlKQllDpBQ9Uc_QjknBCeesf452VAlKeKfkJXpZygOtuGLNC3TJW06ZZN0O_TykxYRwwsHMJqdi0-wtLnMAiGTOUCD_8PH-10usm6MP64TDaZqPOCYHBTtfCtjFp4h9xNk4b03Ay2aL701Zcl2m6fQBm4jTFP0AJm-OEyzH5K7QxWhCgVdPc48On24PN1_I3bfPX28-3hErOr4Q3jdKtoPlVtCBCzO2DIwDx1wre-UMcCcYZQ7M2HQCnO1GNVDVNKqjrenFHl2fbeecvq9QFj35YiEEEyGtRbOurzrR1hj36O0_6ENac6yf2yjZdkJyXil2pmwNrWQY9Zz9ZPJJM6q3cvS5HF3L0Vs5WlXNmyfndZjA_VH8bqMC_AyUeYsI8l-n_-v6CGWhnKQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1784673422</pqid></control><display><type>article</type><title>Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method</title><source>MEDLINE</source><source>Springer Online Journals Complete</source><creator>Wang, Wei ; Liu, Zhiwei ; Xiong, Wenjun ; Zheng, Yansheng ; Luo, Lijie ; Diao, Dechang ; Wan, Jin</creator><creatorcontrib>Wang, Wei ; Liu, Zhiwei ; Xiong, Wenjun ; Zheng, Yansheng ; Luo, Lijie ; Diao, Dechang ; Wan, Jin</creatorcontrib><description>Objective
To investigate the feasibility and safety of laparoscopic spleen-preserving splenic hilum lymph nodes (LNs) dissection for advanced proximal gastric cancer using an omnibearing method.
Methods
Between August 2013 and December 2014, 16 patients with advanced proximal gastric cancer treated in Guangdong Province Hospital of Chinese Medicine, were enrolled and subsequently underwent laparoscopic radical total gastrectomy (TG) with spleen-preserving splenic hilum LNs dissection. During dissecting Nos. 10 and 11 LNs, we divided them into two parts, namely LNs anterosuperior and posterior to the splenic vessel. The clinicopathological characteristics, intraoperative outcomes and postoperative courses were retrospectively collected and analyzed in the study.
Results
Laparoscopic surgery was successfully completed in all 16 patients without conversion to open surgery, and no perioperative death occurred. The mean operating time was 328.75 ± 46.96 min, and the mean estimated blood loss was 135.63 ± 62.07 ml. One patient experienced intraoperative bleeding due to the splenic vein injury which was successfully handled with laparoscopic vessel suturing, and one postoperative pulmonary infection was recorded. The mean time to first flatus was 3.56 ± 1.03 days with a mean 9.63 ± 1.50 days of postoperative hospital stay. The mean number of retrieved LNs was 28.31 ± 5.99, in which LNs anterosuperior to splenic artery was 2.88 ± 2.66 and LNs posterior was 1.38 ± 1.75.
Conclusion
Laparoscopic TG with spleen-preserving splenic hilum LNs dissection using an omnibearing method for advanced proximal gastric cancer was safe and technically feasible in experienced hands. Further studies in terms of its clinical significance are needed.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-015-4438-9</identifier><identifier>PMID: 26201417</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Carcinoma - surgery ; Conversion to Open Surgery ; Dissection ; Feasibility Studies ; Female ; Gastrectomy - methods ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Hospitals ; Humans ; Intraoperative Complications - surgery ; Laparoscopy ; Laparoscopy - methods ; Length of Stay ; Lymph Node Excision - methods ; Lymph Nodes - pathology ; Lymphatic system ; Male ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Operative Time ; Organ Sparing Treatments ; Pancreas ; Patients rights ; Postoperative Complications - epidemiology ; Proctology ; Retrospective Studies ; Spleen ; Spleen - surgery ; Splenic Artery ; Splenic Vein - injuries ; Splenic Vein - surgery ; Stomach Neoplasms - surgery ; Surgeons ; Surgery ; Suture Techniques ; Veins & arteries</subject><ispartof>Surgical endoscopy, 2016-05, Vol.30 (5), p.2030-2035</ispartof><rights>Springer Science+Business Media New York 2015</rights><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-285946bc2c30b23af61eaded1d6489dae2d3101deaf573edc7f9b09559706a83</citedby><cites>FETCH-LOGICAL-c372t-285946bc2c30b23af61eaded1d6489dae2d3101deaf573edc7f9b09559706a83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-015-4438-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-015-4438-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26201417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Wei</creatorcontrib><creatorcontrib>Liu, Zhiwei</creatorcontrib><creatorcontrib>Xiong, Wenjun</creatorcontrib><creatorcontrib>Zheng, Yansheng</creatorcontrib><creatorcontrib>Luo, Lijie</creatorcontrib><creatorcontrib>Diao, Dechang</creatorcontrib><creatorcontrib>Wan, Jin</creatorcontrib><title>Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Objective
To investigate the feasibility and safety of laparoscopic spleen-preserving splenic hilum lymph nodes (LNs) dissection for advanced proximal gastric cancer using an omnibearing method.
Methods
Between August 2013 and December 2014, 16 patients with advanced proximal gastric cancer treated in Guangdong Province Hospital of Chinese Medicine, were enrolled and subsequently underwent laparoscopic radical total gastrectomy (TG) with spleen-preserving splenic hilum LNs dissection. During dissecting Nos. 10 and 11 LNs, we divided them into two parts, namely LNs anterosuperior and posterior to the splenic vessel. The clinicopathological characteristics, intraoperative outcomes and postoperative courses were retrospectively collected and analyzed in the study.
Results
Laparoscopic surgery was successfully completed in all 16 patients without conversion to open surgery, and no perioperative death occurred. The mean operating time was 328.75 ± 46.96 min, and the mean estimated blood loss was 135.63 ± 62.07 ml. One patient experienced intraoperative bleeding due to the splenic vein injury which was successfully handled with laparoscopic vessel suturing, and one postoperative pulmonary infection was recorded. The mean time to first flatus was 3.56 ± 1.03 days with a mean 9.63 ± 1.50 days of postoperative hospital stay. The mean number of retrieved LNs was 28.31 ± 5.99, in which LNs anterosuperior to splenic artery was 2.88 ± 2.66 and LNs posterior was 1.38 ± 1.75.
Conclusion
Laparoscopic TG with spleen-preserving splenic hilum LNs dissection using an omnibearing method for advanced proximal gastric cancer was safe and technically feasible in experienced hands. Further studies in terms of its clinical significance are needed.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Carcinoma - surgery</subject><subject>Conversion to Open Surgery</subject><subject>Dissection</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intraoperative Complications - surgery</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Lymph Node Excision - methods</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Organ Sparing Treatments</subject><subject>Pancreas</subject><subject>Patients rights</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Spleen</subject><subject>Spleen - surgery</subject><subject>Splenic Artery</subject><subject>Splenic Vein - injuries</subject><subject>Splenic Vein - surgery</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Suture Techniques</subject><subject>Veins & arteries</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUuLFDEUhYM4OG2PP8CNBNzMJppXPeJOhvEBA256H1LJrekMqaRMqoRe-dcnZY8igqsLud85N5yD0GtG3zFKu_eFUtlKQllDpBQ9Uc_QjknBCeesf452VAlKeKfkJXpZygOtuGLNC3TJW06ZZN0O_TykxYRwwsHMJqdi0-wtLnMAiGTOUCD_8PH-10usm6MP64TDaZqPOCYHBTtfCtjFp4h9xNk4b03Ay2aL701Zcl2m6fQBm4jTFP0AJm-OEyzH5K7QxWhCgVdPc48On24PN1_I3bfPX28-3hErOr4Q3jdKtoPlVtCBCzO2DIwDx1wre-UMcCcYZQ7M2HQCnO1GNVDVNKqjrenFHl2fbeecvq9QFj35YiEEEyGtRbOurzrR1hj36O0_6ENac6yf2yjZdkJyXil2pmwNrWQY9Zz9ZPJJM6q3cvS5HF3L0Vs5WlXNmyfndZjA_VH8bqMC_AyUeYsI8l-n_-v6CGWhnKQ</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Wang, Wei</creator><creator>Liu, Zhiwei</creator><creator>Xiong, Wenjun</creator><creator>Zheng, Yansheng</creator><creator>Luo, Lijie</creator><creator>Diao, Dechang</creator><creator>Wan, Jin</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160501</creationdate><title>Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method</title><author>Wang, Wei ; Liu, Zhiwei ; Xiong, Wenjun ; Zheng, Yansheng ; Luo, Lijie ; Diao, Dechang ; Wan, Jin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-285946bc2c30b23af61eaded1d6489dae2d3101deaf573edc7f9b09559706a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Carcinoma - surgery</topic><topic>Conversion to Open Surgery</topic><topic>Dissection</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intraoperative Complications - surgery</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay</topic><topic>Lymph Node Excision - methods</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Organ Sparing Treatments</topic><topic>Pancreas</topic><topic>Patients rights</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Spleen</topic><topic>Spleen - surgery</topic><topic>Splenic Artery</topic><topic>Splenic Vein - injuries</topic><topic>Splenic Vein - surgery</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Suture Techniques</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Wei</creatorcontrib><creatorcontrib>Liu, Zhiwei</creatorcontrib><creatorcontrib>Xiong, Wenjun</creatorcontrib><creatorcontrib>Zheng, Yansheng</creatorcontrib><creatorcontrib>Luo, Lijie</creatorcontrib><creatorcontrib>Diao, Dechang</creatorcontrib><creatorcontrib>Wan, Jin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Wei</au><au>Liu, Zhiwei</au><au>Xiong, Wenjun</au><au>Zheng, Yansheng</au><au>Luo, Lijie</au><au>Diao, Dechang</au><au>Wan, Jin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>30</volume><issue>5</issue><spage>2030</spage><epage>2035</epage><pages>2030-2035</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Objective
To investigate the feasibility and safety of laparoscopic spleen-preserving splenic hilum lymph nodes (LNs) dissection for advanced proximal gastric cancer using an omnibearing method.
Methods
Between August 2013 and December 2014, 16 patients with advanced proximal gastric cancer treated in Guangdong Province Hospital of Chinese Medicine, were enrolled and subsequently underwent laparoscopic radical total gastrectomy (TG) with spleen-preserving splenic hilum LNs dissection. During dissecting Nos. 10 and 11 LNs, we divided them into two parts, namely LNs anterosuperior and posterior to the splenic vessel. The clinicopathological characteristics, intraoperative outcomes and postoperative courses were retrospectively collected and analyzed in the study.
Results
Laparoscopic surgery was successfully completed in all 16 patients without conversion to open surgery, and no perioperative death occurred. The mean operating time was 328.75 ± 46.96 min, and the mean estimated blood loss was 135.63 ± 62.07 ml. One patient experienced intraoperative bleeding due to the splenic vein injury which was successfully handled with laparoscopic vessel suturing, and one postoperative pulmonary infection was recorded. The mean time to first flatus was 3.56 ± 1.03 days with a mean 9.63 ± 1.50 days of postoperative hospital stay. The mean number of retrieved LNs was 28.31 ± 5.99, in which LNs anterosuperior to splenic artery was 2.88 ± 2.66 and LNs posterior was 1.38 ± 1.75.
Conclusion
Laparoscopic TG with spleen-preserving splenic hilum LNs dissection using an omnibearing method for advanced proximal gastric cancer was safe and technically feasible in experienced hands. Further studies in terms of its clinical significance are needed.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26201417</pmid><doi>10.1007/s00464-015-4438-9</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Springer Online Journals Complete |
| subjects | Abdominal Surgery Aged Carcinoma - surgery Conversion to Open Surgery Dissection Feasibility Studies Female Gastrectomy - methods Gastric cancer Gastroenterology Gastrointestinal surgery Gynecology Hepatology Hospitals Humans Intraoperative Complications - surgery Laparoscopy Laparoscopy - methods Length of Stay Lymph Node Excision - methods Lymph Nodes - pathology Lymphatic system Male Medicine Medicine & Public Health Metastasis Middle Aged Operative Time Organ Sparing Treatments Pancreas Patients rights Postoperative Complications - epidemiology Proctology Retrospective Studies Spleen Spleen - surgery Splenic Artery Splenic Vein - injuries Splenic Vein - surgery Stomach Neoplasms - surgery Surgeons Surgery Suture Techniques Veins & arteries |
| title | Totally laparoscopic spleen-preserving splenic hilum lymph nodes dissection in radical total gastrectomy: an omnibearing method |
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