The "quadrant-sandwich" method in clockwise modular D2 lymph node dissection in laparoscopic total gastrectomy: a...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic radical gastrectomy requires meticulous lymph node dissection (LND) and optimized surgical procedures.
• The
• quadrant-sandwich
• method is a novel approach for clockwise modular D2 LND.

Purpose of the Study:

• To evaluate the advantages and safety of the
• quadrant-sandwich
• method in laparoscopic radical gastrectomy.
• To compare the outcomes of this method against traditional LND techniques.

Main Methods:

• Retrospective analysis of 108 laparoscopic total gastrectomy patients.
• Comparison between an observation group ( 55 patients) using the
• quadrant-sandwich
• method and a control group ( 53 patients) using traditional LND.
• Evaluation of operation time, blood loss, lymph node yield, and postoperative recovery.

Main Results:

• The
• quadrant-sandwich
• group showed significantly shorter operation times ( 227.0±48.5 min vs 247±41.5 min) and less intraoperative bleeding ( 100.0 mL vs 180.0 mL) compared to the control group (P<0.05).
• No significant differences were observed in lymph node yield or postoperative complications between the groups.
• Baseline data and postoperative recovery metrics were comparable between the two groups.

Conclusions:

• Clockwise modular D2 LND using the
• quadrant-sandwich
• method is safe and feasible for laparoscopic total gastrectomy.
• This technique ensures thorough LND while improving surgical efficiency.
• The method leads to reduced operation time and intraoperative bleeding.