Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic approach in radical gastrectomy for advanced gastric cancer
10.3760/cma.j.issn.1673-9752.2012.01.017
- VernacularTitle:胰后入路保留胰脾的原位脾门淋巴结清扫在腹腔镜胃癌根治术中的应用
- Author:
Guoxin LI
;
Tingyu MOU
;
Jiang YU
;
Yanan WANG
;
Yanfeng HU
- Publication Type:Journal Article
- Keywords:
Gastric neoplasms;
Laparoscopy;
Gastrectomy;
Lymph node dissection
- From:
Chinese Journal of Digestive Surgery
2012;11(1):58-60
- CountryChina
- Language:Chinese
-
Abstract:
Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection is still difficult to accomplish,which restrains its application in total gastrectomy for advanced proximal gastric cancer.Based on our anatomical understanding of pre- and retropancreatic spaces,features of splenic vessels and distribution of perigastric lymph nodes,we combined the characteristics of laparoscopic surgery and developed a novel technique for laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic space.The key lies in mobilization of the splenic pedicle through retropancreatic space,dissection of peri-vascular lymph nodes in sequence of trunk-to-branch,in-sheath vascularization of the splenic vessels.From August 2009 to December 2010,this technique was performed on 6 patients in Nanfang hospital.The initial results suggested that this technique could be safe and feasible for skillful surgeons.Further studies on the application of this technique in total gastrectomy for advanced proximal gastric cancer would be needed.
