Intraoperative sentinel lymph node mapping guides laparoscopic-assisted distal gastrectomy for distal gastric cancer

The aim of this retrospective study is to explore the effects of sentinel lymph node (SLN) mapping guided laparoscopic-assisted distal gastrectomy (LADG) for distal gastric cancer. Two hundred patients were enrolled in this study. One hundred and one patients undergoing SLN guided LADG were designated as the SLN group. Ninety-nine patients having conventional LADG with D1 or D2 lymph node dissection were designated as the control group. Intraoperative and postoperative indicators such as the number of lymph nodes dissected, intraoperative and postoperative conditions, flow cytometry analysis of T lymphocyte subsets and natural killer (NK) cells, survival rates, recurrence rates and postoperative complications were investigated between these two groups. The number of lymph nodes dissected in the SLN group was significantly lesser than that in the control group. Furthermore, in the SLN group, the patients achieved better immunization status, improved intraoperative and postoperative conditions and decreased postoperative complications. There were no significant differences were found in the positive lymph nodes detected, the distance between proximal and distal cutting edge, postoperative survival or recurrence rates. SLN guided LADG for gastric cancer is a safe and effective method and could achieve an equal clinical effect as traditional laparoscopic D1 or D2 radical operation with less operation trauma and better recovery.