Laparoscopic splenic hilar lymphadenectomy for advanced gastric cancer

Hosogi, Hisahiro; Okabe, Hiroshi; Shinohara, Hisashi; Tsunoda, Shigeru; Hisamori, Shigeo; Sakai, Yoshiharu

doi:10.21037/tgh.2016.03.20

Cited by 8 publications

(5 citation statements)

References 32 publications

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“…Therefore, some surgeons prefer splenectomy to splenic hilar LND. Moreover, there are debates regarding the feasibility of laparoscopic spleen-preserving splenic hilar LND and splenectomy [ 24 25 26 ]. As there was no definite indication for splenectomy in our study, splenic hilar dissection was mostly performed with spleen preservation.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Totally Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer: Comparison with Early Gastric Cancer

Lee

2018

J Gastric Cancer

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PurposeTotally laparoscopic gastrectomy (TLG) for advanced gastric cancer (AGC) is a technically and oncologically challenging procedure for surgeons. This study aimed to compare the oncologic feasibility and technical safety of TLG for AGC versus early gastric cancer (EGC).Materials and MethodsBetween 2011 and 2016, 535 patients (EGC, 375; AGC, 160) underwent curative TLG for gastric cancer. Clinicopathologic characteristics and surgical outcomes of both patient groups were analyzed and compared.ResultsPatients with AGC required a longer operation time and experienced more intraoperative blood loss than those with EGC did. However, patients from both the AGC and EGC groups demonstrated similar short-term surgical outcomes such as postoperative morbidity (14.4% vs. 13.3%, P=0.626), mortality (0% vs. 0.5%, P=0.879), time-to-first oral intake (2.7 days for both groups, P=0.830), and postoperative hospital stay (10.2 days vs. 10.1 days, P=0.886). D2 lymph node dissection could be achieved in the AGC group (95%), with an adequate number of lymph nodes being dissected (36.0±14.9). In the AGC group, the 3-year overall and disease-free survival rates were 80.5% and 73.7%, respectively.ConclusionsTLG is as safe and effective for AGC as it is for EGC.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Totally Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer: Comparison with Early Gastric Cancer

Lee

2018

J Gastric Cancer

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“…Probably most widely regarded as the most difficult part of D2 lymphadenectomy (in total gastrectomy) is the splenic hilar lymphadenectomy (station 10). Hosogi and colleagues summarized literature with the results of laparoscopic splenic hilar lymphadenectomy [ 35 ]. The mean number of harvested nodes in this area varied from 0 to 5.…”

Section: Discussionmentioning

confidence: 99%

Compliance to D2 lymphadenectomy in laparoscopic gastrectomy

et al. 2018

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The objective of this study is to describe the compliance to D2 lymphadenectomy in laparoscopic gastrectomy. Radical partial or total gastrectomy with modified D2 lymphadenectomy is the standard of care for locally advanced gastric cancer. It is unclear whether compliance to D2 lymphadenectomy in laparoscopy is comparable to that in open surgery. A review of the literature was performed and results are described in a descriptive review. Available randomized trials are mostly performed for early gastric cancer, for which formal D2 lymphadenectomy is usually not required. Most trials report no differences in number of retrieved lymph nodes between open and laparoscopic gastrectomy. Only one trial used adherence to D2 lymphadenectomy as primary outcome parameter, and found no difference between laparoscopic and open gastrectomy. Results from randomized trials in advanced gastric cancer are awaited. In the meantime, the laparoscopic approach can be used in experienced centers.

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“…Therefore, some researchers are inclined to adopt SPSHL for AUMGC. Moreover, laparoscopic SPSHL (LSPSHL) has been increasingly reported and has been proven to be safe and feasible with a better minimally invasive effect (Hyung et al 2008;Sakuramoto et al 2009;Hosogi et al 2016;Guo et al 2018). Thus, in this study, we further assessed the survival bene t of LSPSHL based on the comparison of long-term survival of patients undergoing laparoscopic total gastrectomy (LTG) with SPSHL and laparoscopic distal gastrectomy (LDG) with standard D2 lymphadenectomy.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Splenic Hilar Lymph Node Dissection is Recommended for Pathologic Stage IIIA Middle and Upper Gastric Cancer: A Comparative Study with Standard D2 Laparoscopic Distal Gastrectomy

Huang

Tang

et al. 2021

Preprint

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Purpose D2 lymphadenectomy is considered a standard procedure for distal gastrectomy (DG). However, whether splenic hilar (No. 10) lymph node (LN) should be included in the extent of D2 lymphadenectomy for total gastrectomy (TG) is still controversial. Therefore, we assessed the survival benefit of laparoscopic No.10 LN dissection based on the comparison of long-term survival of patients undergoing laparoscopic TG (LTG) with laparoscopic No.10 LN dissection and laparoscopic DG (LDG). Methods The clinicopathological data of 2069 patients who underwent laparoscopic radical gastrectomy were retrospectively analyzed. The survival of the LDG group, the LTG with dissection of No. 10 LN (LTG+No. 10) group and the LTG without dissection of No. 10 LN (LTG-No. 10) group was compared. Results After adjusting for age, pT stage, pN stage and pTNM stage by 1:1:1 propensity score matching (PSM), there were 373 patients in each group. Kaplan-Meier (K-M) survival analysis showed that only in the pIIIA stage, the 5-year survival overall survival (OS) and cancer specific survival (CSS) of the LTG+No. 10 group was significantly better than that of the LTG-No. 10 group and comparable with that of the LDG group. Multivariate Cox regression analyses showed that dissection of No. 10 LN was an independent favorable factor for OS and CSS in all patients and patients with pIIIA. Conclusion In patients with stage pIIIA, those undergoing LTG with No. 10 LN dissection could achieve a long-term outcome comparable to that of patients at the same pathological stage undergoing LDG.

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Laparoscopic splenic hilar lymphadenectomy for advanced gastric cancer

Cited by 8 publications

References 32 publications

Feasibility and Safety of Totally Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer: Comparison with Early Gastric Cancer

Feasibility and Safety of Totally Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer: Comparison with Early Gastric Cancer

Compliance to D2 lymphadenectomy in laparoscopic gastrectomy

Laparoscopic Splenic Hilar Lymph Node Dissection is Recommended for Pathologic Stage IIIA Middle and Upper Gastric Cancer: A Comparative Study with Standard D2 Laparoscopic Distal Gastrectomy

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