Application value of antegrade splenic superior region dissection first in laparoscopic total gastrectomy of obesity gastric cancer
10.3760/cma.j.cn115610-20240119-00029
- VernacularTitle:脾上极优先顺行路径在肥胖症胃癌腹腔镜全胃切除术中的应用价值
- Author:
Danhua XU
1
;
Jiayi GU
;
Xinli MA
;
Chunchao ZHU
;
Ming WANG
;
Enhao ZHAO
;
Zizhen ZHANG
;
Jiangfeng QIU
;
Hui CAO
Author Information
1. 上海交通大学医学院附属仁济医院胃肠外科，上海 200127
- Keywords:
Stomach neoplasms;
Obesity;
Laparoscopic total gastrectomy;
Surgical app-roach;
Splenogastric ligament;
Gastric short vessel
- From:
Chinese Journal of Digestive Surgery
2024;23(4):609-612
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of antegrade splenic superior region dissection first in laparoscopic total gastrectomy of obesity gastric cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 21 obesity patients with gastric cancer who underwent laparoscopic total gastrectomy in Renji Hospital of Shanghai Jiaotong University School of Medicine from July 2018 to October 2023 were collected. There were 16 males and 5 females, aged (58±13)years. All 21 patients underwent laparoscopic total gastrec-tomy with antegrade splenic superior region dissection first. Observation indicators: operation time, volume of intraoperative blood loss, laparotomy conversion, intraoperative splenic hemorrhage or gastric hemorrhage, lymph node dissection, time to postoperative first flatus, time to postoperative initial liquid food intake, duration of postoperative hospital stay, postoperative complication. Measure-ment data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:All 21 patients underwent laparoscopic total gastrectomy success-fully, with the operation time of (283±47)minutes, time for splenogastric ligament and vascular manage-ment of (34±12)minutes, volume of intraoperative blood loss of (143±86)mL, and no laparotomy conversion. There was no intraoperative splenic hemorrhage or gastric haemorrhage. The total number of lymph node dissected in 21 patients was 375, with the number of lymph node dissected as (21±9)per case. Time to postoperative first flatus, time to postoperative initial liquid food intake and duration of postoperative hospital stay in 21 patients were (3.1±0.7)days, (4.0±0.8)days and (10.1±3.0)days, respectively. There were 2 patients with postoperative complications, including 1 case of incision infection and 1 case of lung infection. The 2 patients with postoperative com-plications were recovered and discharged after conservative treatment. There was no death during the postoperative 30 days.Conclusion:The application of antegrade splenic superior region dissec-tion first in laparoscopic total gastrectomy is safe and feasible, which can reduce surgical difficulty.
