Background: Laparoscopic surgery (LS) for remnant gastric cancer (RGC) is gaining interest [1-3]. However, due to adhesions to adjacent organs, displacement of anatomical structures, and changes in lymphatic flow triangulation, LS for RGC is considered challenging. In this study, we report our experience performing laparoscopic lymph node dissection for RGC following Billroth-II gastrectomy.
Methods: The procedure was separated into five steps: (1) exploration and separation of adhesions and the greater omentum; (2) dissection of the lymph nodes (LNs) in the suprapancreatic area; (3) exposing the right side of the esophagus; (4) exposing the left gastroepiploic vessels and dissection of the LNs in the splenic hilar area; and (5) exposing the left side of the esophagus. The above procedure was performed for 45 RGC patients with stage cT1-4aN0/+ disease from January 2008 to June 2017.
Results: There were no conversions to open surgery. The mean operation time was 195.0 ± 52.5 min, the mean blood loss was 104.3 ± 90.4 ml, and the mean times to first flatus, fluid diet, and soft diet were 3.6 ± 1.1 days, 4.5 ± 1.4 days, and 9.0 ± 5.1 days, respectively. A mean of 19.8 ± 12.7 LNs were retrieved. The overall postoperative morbidity rate, major postoperative morbidity [4] rate and mortality rate were 22.2%, 11.1%, and 0%, respectively. At a median follow-up of 47 months, the cumulative 3-year overall survival rate was 56.8%.
Conclusions: This novel "five-step" laparoscopic lymph node dissection approach was technically safe and feasible in RGC patients following Billroth-II gastrectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.suronc.2019.09.007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Retrospective Study of Laparoscopic Distal Gastrectomy Guided by Carbon Nanoparticle Suspension Injection Lymphography for Gastric Cancer.
Am Surg
January 2025
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background: The use of lymph node (LN) tracers can help obtain a complete dissection of the LNs and increase the detection rate of metastatic LNs. Carbon nanoparticle suspension injection (CNSI) has become increasingly used in radical gastrectomy procedures. This study is designed to evaluate the quality of LN dissection in gastric cancer patients with laparoscopic distal gastrectomy under the guidance of CNSI lymphography.
View Article and Find Full Text PDFIndocyanine green highlights the lymphatic drainage pathways, enhancing the effectiveness of radical surgery for mid-low rectal cancer: A non-randomized controlled prospective study.
Eur J Surg Oncol
December 2024
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China. Electronic address:
Background: Fluorescence-guided lymphadenectomy (FLND) using indocyanine green (ICG) has emerged as a promising technique to enhance the accuracy of lymphadenectomy in rectal cancer surgery. Effective lymphadenectomy is crucial for improving prognosis in patients with advanced rectal cancer, but it remains technically challenging and controversial.
Methods: This prospective nonrandomized controlled study was conducted involving 129 patients underwent laparoscopic surgery, and 64 patients assisted by FLND.
Preoperative Indocyanine Green Tattooing for Robotic-Assisted Surgery in Rectal Cancer.
Asian J Endosc Surg
January 2025
Department of Surgery, Chibanishi General Hospital, Chiba, Japan.
Introduction: Preoperative identification of the site of rectal cancer surgery is crucial for ensuring accurate tumor localization and resection. Commonly employed methods include contrast-enhanced enterography and endoscopic marking techniques, such as clipping and India ink tattooing. However, India ink tattooing poses challenges, including obstruction of the surgical field, ink leakage into the abdominal cavity, and potential complications such as peritonitis and adhesive bowel obstruction.
View Article and Find Full Text PDFLaparoscopic surgery is associated with increased risk of postoperative peritoneal metastases in T4 colon cancer: a propensity score analysis.
Int J Colorectal Dis
January 2025
Department of Colorectal Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China.
Background: This study aims to evaluate the postoperative safety, long-term survival, and postoperative peritoneal metastases (PPM) rate associated with laparoscopic surgery (LS) for T4 colon cancer.
Materials And Methods: After propensity score matching, there were 68 patients in each of the LS and Open surgery groups. The primary outcomes were the 3-year OS, DFS, and PPM rates.
Outcomes of Laparoscopic Radical Hysterectomy in Ia1-Ib1 Cervical Cancer Patients: A Multi-Center Study with 10 Years' Experiences in the Real World.
Ann Surg Oncol
December 2024
Department of Gynecologic Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine Central, South University/Hunan Cancer Hospital, Changsha, People's Republic of China.
Article Synopsis
- The study assessed laparoscopic radical hysterectomy (LRH) outcomes in early-stage, low-risk cervical cancer patients compared to open abdominal radical hysterectomy (OARH).
- In low-risk cases, 5-year overall and progression-free survival rates were similar for LRH (98.6% OS, 97.6% PFS) and OARH (99.3% OS, 98.4% PFS), with no significant differences found.
- Conversely, in high-risk patients, LRH showed lower survival rates compared to OARH, indicating the need for careful surgical approach selection based on risk factors and imaging prior to surgery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!