A retrospective study on an innovative modular surgical technique in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy
10.3760/cma.j.cn441530-20241216-00407
- VernacularTitle:“幕帘化”淋巴结清扫技术在腹腔镜下全胃切除术联合保脾的脾门淋巴结清扫术的安全性分析
- Author:
Wenjuan LI
1
;
Dechang DIAO
;
Xin TANG
;
Jiaqi REN
;
Ziyan HE
;
Xueyang ZHANG
;
Bing ZENG
;
Xiaochuang FENG
;
Weilin LIAO
;
Yingnan HU
Author Information
1. 广州中医药大学第二临床医学院，广州 510405
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms, advanced proximal , greater curvature;
Innovative modular surgical technique;
Spleen-preserving hilar lymphadenectomy;
Laparoscopic to
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(9):1059-1063
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to propose an innovative modular surgical technique and explore its safety and application value in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy for advanced proximal gastric cancer invading the greater curvature.Methods:A retrospective collection was conducted on 34 patients with proximal gastric cancer invading the greater curvature who underwent laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy in the same center from October 2020 to December 2022. The technical key points, precautions and crucial steps of the modular surgical technique were summarized, and the Clinical indicators were analyzed.Results:All 34 patients successfully completed the operation under laparoscopy without conversion to open surgery. The average operation duration was 151.9±4.1 minutes, and the duration of splenic hilar lymphadenectomy was 12.9±1.5 minutes. The median intraoperative blood loss was 50(20, 50) ml, and the blood loss during splenic hilar lymphadenectomy was 5 (2, 5) ml. The median number of harvested lymph nodes was 32.0 (23.5,39.5), and the number of submitted No.10 lymph nodes was 3 (2, 4). The metastasis rate of No.10 lymph nodes was 20.6% (7/34). No patient had intraoperative complications. During the postoperative hospital stay, one patient had incision infection (Clavien-Dindo I), and one patient had pulmonary infection (Clavien-Dindo II). The time for the first postoperative feeding was 3 (2, 5) days, the time for the first postoperative flatus was 2 (2,3) days, the time for the first postoperative defecation was 3 (3, 4) days, the total postoperative drainage volume was 1047.5 (607.5,1397.5) mL, the time for postoperative drainage tube removal was 7 (6, 9) days, and the length of postoperative hospital stay was 7.0 (6.0, 9.5) days.Conclusions:The application of the innovative modular surgical technique in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy can simplify surgical process and enable safe, precise and comprehensive dissection of splenic hilar lymph nodes.
