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Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma
Published on: August 9, 2016
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Appropriate traction can help identify the optimal dissectable layer for infrapyloric lymph node dissection in
Susumu Miura1, Hisahiro Hosogi1, Hironori Kawada1,2
1Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan.
Asian Journal of Endoscopic Surgery
|July 9, 2020
Summary
Dissecting infrapyloric lymph nodes (no. 6 LNs) from the patient's right side during laparoscopic gastric cancer surgery is safe and effective. This approach ensures oncologic reliability and simplifies dissection for surgeons.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Dissection of infrapyloric lymph nodes (no. 6 LNs) is crucial in gastric cancer surgery.
- Laparoscopic dissection from the left side presents traction challenges.
- Identifying an optimal dissection layer from the right side is needed.
Purpose of the Study:
- To identify an optimal dissection layer for no. 6 LNs from the patient's right side.
- To evaluate the oncologic reliability of this layer.
- To assess the safety of this laparoscopic approach.
Main Methods:
- Retrospective analysis of laparoscopic distal gastrectomy outcomes (April 2011-March 2013).
- Dissection of no. 6 LNs performed from the patient's right side.
- Evaluation of lymph node yield, dissection time, and complications.
Main Results:
- 112 patients analyzed; median of five no. 6 LNs resected.
- Median dissection time was 14 minutes.
- No recurrence in no. 6 LNs observed; low rates of pancreatic fistula and abscess.
Conclusions:
- The identified optimal layer is oncologically reliable for no. 6 LN dissection.
- Laparoscopic dissection of no. 6 LNs from the right side is a safe procedure.
- This technique overcomes traction difficulties associated with left-sided dissection.
