[Analysis of lymph node dissection patterns in D2 radical gastrectomy by hand-assisted laparoscopic technique]

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Gastric cancer treatment often involves radical gastrectomy with lymph node dissection.
• Minimally invasive approaches like laparoscopy are increasingly adopted for improved patient outcomes.
• Standardization of surgical techniques is crucial for consistent results in complex procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel lymph node dissection pattern in hand-assisted laparoscopic radical gastrectomy.
• To assess the feasibility of the reverse lymph nodes scavenge pattern for D2 lymphadenectomy.
• To analyze surgical outcomes and complications associated with this technique.

Main Methods:

• Retrospective analysis of 111 patients undergoing hand-assisted laparoscopic radical gastrectomy.
• Implementation of a specific 'reverse lymph nodes scavenge pattern' for lymph node dissection.
• Data collection on patient demographics, surgical procedures, operative parameters, and postoperative outcomes.

Main Results:

• The study included various gastrectomy types (total, distal, proximal) and TNM stages.
• Low average incision length (6.8±0.3 cm), minimal blood loss (238.4±113.6 ml), and operative time (171.9±23.3 min).
• A low postoperative complication rate of 9.0% was observed, with one perioperative death.

Conclusions:

• Hand-assisted laparoscopic D2 radical gastrectomy using the reverse lymph nodes scavenge pattern is feasible and safe.
• This technique facilitates standardization of surgical procedures and avoids open conversions.
• It represents a valuable advancement in minimally invasive surgical management of gastric cancer.