Experience Summary on Group No.6 Lymphadenectomy of Laparoscopic Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer in 141 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUJin-sheng ,  HUANGLiang-xiang , ZENGChang-qing , LIJian-dang , HEXie

Department of Gastrointestinal Surgery of Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou 350001, Fujian Province, China;

Corresponding?author：

HUANGLiang-xiang, Email: 48448397@qq.com

Keywords：

Gastric cancer; Laparoscopic operation; Lymphadenectomy; Anatomy

DOI：

10.7507/1007-9424.20140106

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To study the significance, methods, and technique of group No.6 lymphadenectomy of the laparoscopic gastrectomy with D2 lymph node dissection for distal gastric cancer. Methods The relevant data of the 141 examples of group No.6 lymphadenectomy of the laparoscopic gastrectomy with D2 lymph node dissection for distal gastric cancer from Jan.1, 2008 to Dec.31, 2011 were retrospectively analysized. Results One hundred and forty-one patients were successfully completed the group No.6 lymphadenectomy of laparoscopic distal gastrectomy with D2 lymph node dissection. With the number of cases of operation increasing, the operation time, bleeding volume, incidence rate of complication, and the number of operation transit cases stepped down year by year, and the number of the lymph node dissection stepped up (P < 0.000 1). No case died of the lymphadenectomy of the group No.6 lymph node. The medium vessels of colon, pancreas, and the gastroduodenal artery were the anatomic landmarks of the group No.6 lymphadenectomy. The space between the anterior lobe and the posterior lobe of transverse mesocolon and the prepancreatic space were the important surgical plane to carry out the group No.6 lymphadenectomy. Conclusions Only a team shall complete a certain amount of the operation, take the medium vessels of colon, pancreas, and the gastroduodenal artery as the anatomic landmark, accurately identify the space between the anterior lobe and the posterior lobe of transverse mesocolon, and the prepancreatic space, and take operation on the correct surgical plane, shall the group No.6 lymphadenectomy conform to the principle of the radical cure of the tumour and achieve the aim of the minimal invasion.

Citation： LIUJin-sheng, HUANGLiang-xiang, ZENGChang-qing, LIJian-dang, HEXie. Experience Summary on Group No.6 Lymphadenectomy of Laparoscopic Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer in 141 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(4): 437-441. doi: 10.7507/1007-9424.20140106 Copy

1.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy[J]. Surg Laparosc Endosc, 1994, 4(2):146-148.
2.	Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer[J]. Gastric cancer, 2006, 9(3):167-176.
3.	Japan Society for Endoscopic Surgery (2008) Nationwide survey on endoscopic surgery in Japan.Jpn Soc Endosc Surg, 2008, 13(5):499-604.
4.	李國立, 李寧, 黎介壽.胃癌根治術中對第6組淋巴結清掃的方法及其意義[J].外科理論與實踐, 2005, 10(5):466-467.
5.	李國新.腹腔鏡遠端胃癌D2淋巴廓清的解剖學思路[J].中華胃腸外科雜志, 2010, 13(6):400-402.
6.	Zhang M, Zhu G, Ma Y, et al. Comparison of four staging systems of lymph node metastasis in gastric cancer[J]. World J Surg, 2009, 33(11):2383-2388.
7.	Bilici A, Seker M, Ustaalioglu BBO, et al. Determining of metas-tatic lymph node ratio in patients who underwent D2 dissection for gastric cancer[J]. Med Oncol, 2010, 27(3):975-984.
8.	所劍.胃癌的淋巴結清掃及意義[J].中國普外基礎與臨床雜志, 2010, 17(1):5-7.
9.	湯黎明, 錢峻, 朱杰, 等.腹腔鏡胃癌D2根治術在進展期胃癌中的應用探討[J].中國微創外科雜志, 2009, 8(12):1079-1081.
10.	余佩武, 羅華星.腹腔鏡胃癌根治術的研究進展[J].中華胃腸外科雜志, 2009, 12(2):208-210.
11.	Lee J, Kim W. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer:analysis of consecutive 106 experiences[J]. J Surg Oncol, 2009, 100(8):693-698.
12.	Strong VE, Devaud N, Allen PJ, et al. Laparoscopic versus open subtotal gastrectomy for adenocarcinoma:a case-control study[J]. Ann Surg Oncol, 2009, 16(6):1507-1513.
13.	黃昌明, 林建賢, 鄭朝輝, 等.腹腔鏡輔助胃癌根治術淋巴結清掃效果的臨床對照研究[J].中華外科雜志, 2011, 49(3):200-203.
14.	徐鈞, 張瑞, 董永紅, 等.腹腔鏡輔助與開腹遠端胃癌D2根治術的治療效果比較[J].中華實驗外科雜志, 2012, 29(11):2294-2296.
15.	黃江龍, 衛洪波, 鄭宗珩, 等.進展期遠端胃癌腹腔鏡與開腹根治術的對照研究[J].中華胃腸外科雜志, 2012, 15(6):615-617.
16.	葉再生, 應敏剛, 陳路川, 等.腹腔鏡與開腹行胃癌D2根治術的對照研究及中期隨訪報告[J].中國微創外科雜志, 2013, 13(11):977-981.
17.	Tanimura S, Higashino M, Fukunaga Y, et al. Laparoscopic gastrectomy for gastric cancer:experience with more than 600 cases[J]. Surg Endosc, 2008, 22(5):1161-1164.
18.	Huscher CG, Mingoli A, Sgarzini G, et al. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer:early and long-term results of a 100-patient series[J]. Am J Surg, 2007, 194(6):839-844.
19.	陳鈳, 牟一平, 徐曉武, 等.腹腔鏡輔助根治性全胃切除術的Meta分析[J].中華普通外科雜志, 2012, 27(12):1014-1019.
20.	鐘輝, 馮東亮, 唐昊.腹腔鏡與開腹手術治療胃癌的臨床療效比較[J].中國現代普通外科進展, 2013, 16(8):639-641.
21.	Hayashi H, Ochiai T, Shimada H, et al. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer[J]. Surg Endosc, 2005, 19(9):1172-1176.
22.	李國立, 劉福坤, 黎介壽.不同區域胃癌的"前哨結"及其臨床意義[J].中華外科雜志, 2000, 38(11):879.
23.	李國立, 劉福坤, 曹建民, 等.血管造影對胃癌浸潤深度的診斷及對淋巴結轉移規律的觀察[J].中華外科雜志, 2001, 39(3):232-234.
24.	Nunobe S, Hiki N, Ohyama S, et al. Outcome of surgical treatment for patients with locoregional recurrence of gastric cancer[J]. Langenbecks Arch Surg, 2011, 396(2):161-166.
25.	日本胃癌學會.胃癌取扱い規約[M].第14版.東京:金原出版, 2010:2-18.
26.	張策, 余江, 王亞楠, 等.胰腺和胰周間隙的活體解剖學特點及其對腹腔鏡遠端胃癌D2切除術的啟示[J].中華胃腸外科雜志, 2009, 12(2):117-120.
27.	李國新, 張策, 余江.腹腔鏡輔助遠端胃癌D2根治術:基于解剖的藝術[J].外科理論與實踐, 2008, 12(6):533-538.

1. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy[J]. Surg Laparosc Endosc, 1994, 4(2):146-148.
2. Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer[J]. Gastric cancer, 2006, 9(3):167-176.
3. Japan Society for Endoscopic Surgery (2008) Nationwide survey on endoscopic surgery in Japan.Jpn Soc Endosc Surg, 2008, 13(5):499-604.
4. 李國立, 李寧, 黎介壽.胃癌根治術中對第6組淋巴結清掃的方法及其意義[J].外科理論與實踐, 2005, 10(5):466-467.
5. 李國新.腹腔鏡遠端胃癌D2淋巴廓清的解剖學思路[J].中華胃腸外科雜志, 2010, 13(6):400-402.
6. Zhang M, Zhu G, Ma Y, et al. Comparison of four staging systems of lymph node metastasis in gastric cancer[J]. World J Surg, 2009, 33(11):2383-2388.
7. Bilici A, Seker M, Ustaalioglu BBO, et al. Determining of metas-tatic lymph node ratio in patients who underwent D2 dissection for gastric cancer[J]. Med Oncol, 2010, 27(3):975-984.
8. 所劍.胃癌的淋巴結清掃及意義[J].中國普外基礎與臨床雜志, 2010, 17(1):5-7.
9. 湯黎明, 錢峻, 朱杰, 等.腹腔鏡胃癌D2根治術在進展期胃癌中的應用探討[J].中國微創外科雜志, 2009, 8(12):1079-1081.
10. 余佩武, 羅華星.腹腔鏡胃癌根治術的研究進展[J].中華胃腸外科雜志, 2009, 12(2):208-210.
11. Lee J, Kim W. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer:analysis of consecutive 106 experiences[J]. J Surg Oncol, 2009, 100(8):693-698.
12. Strong VE, Devaud N, Allen PJ, et al. Laparoscopic versus open subtotal gastrectomy for adenocarcinoma:a case-control study[J]. Ann Surg Oncol, 2009, 16(6):1507-1513.
13. 黃昌明, 林建賢, 鄭朝輝, 等.腹腔鏡輔助胃癌根治術淋巴結清掃效果的臨床對照研究[J].中華外科雜志, 2011, 49(3):200-203.
14. 徐鈞, 張瑞, 董永紅, 等.腹腔鏡輔助與開腹遠端胃癌D2根治術的治療效果比較[J].中華實驗外科雜志, 2012, 29(11):2294-2296.
15. 黃江龍, 衛洪波, 鄭宗珩, 等.進展期遠端胃癌腹腔鏡與開腹根治術的對照研究[J].中華胃腸外科雜志, 2012, 15(6):615-617.
16. 葉再生, 應敏剛, 陳路川, 等.腹腔鏡與開腹行胃癌D2根治術的對照研究及中期隨訪報告[J].中國微創外科雜志, 2013, 13(11):977-981.
17. Tanimura S, Higashino M, Fukunaga Y, et al. Laparoscopic gastrectomy for gastric cancer:experience with more than 600 cases[J]. Surg Endosc, 2008, 22(5):1161-1164.
18. Huscher CG, Mingoli A, Sgarzini G, et al. Totally laparoscopic total and subtotal gastrectomy with extended lymph node dissection for early and advanced gastric cancer:early and long-term results of a 100-patient series[J]. Am J Surg, 2007, 194(6):839-844.
19. 陳鈳, 牟一平, 徐曉武, 等.腹腔鏡輔助根治性全胃切除術的Meta分析[J].中華普通外科雜志, 2012, 27(12):1014-1019.
20. 鐘輝, 馮東亮, 唐昊.腹腔鏡與開腹手術治療胃癌的臨床療效比較[J].中國現代普通外科進展, 2013, 16(8):639-641.
21. Hayashi H, Ochiai T, Shimada H, et al. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer[J]. Surg Endosc, 2005, 19(9):1172-1176.
22. 李國立, 劉福坤, 黎介壽.不同區域胃癌的"前哨結"及其臨床意義[J].中華外科雜志, 2000, 38(11):879.
23. 李國立, 劉福坤, 曹建民, 等.血管造影對胃癌浸潤深度的診斷及對淋巴結轉移規律的觀察[J].中華外科雜志, 2001, 39(3):232-234.
24. Nunobe S, Hiki N, Ohyama S, et al. Outcome of surgical treatment for patients with locoregional recurrence of gastric cancer[J]. Langenbecks Arch Surg, 2011, 396(2):161-166.
25. 日本胃癌學會.胃癌取扱い規約[M].第14版.東京:金原出版, 2010:2-18.
26. 張策, 余江, 王亞楠, 等.胰腺和胰周間隙的活體解剖學特點及其對腹腔鏡遠端胃癌D2切除術的啟示[J].中華胃腸外科雜志, 2009, 12(2):117-120.
27. 李國新, 張策, 余江.腹腔鏡輔助遠端胃癌D2根治術:基于解剖的藝術[J].外科理論與實踐, 2008, 12(6):533-538.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience Summary on Group No.6 Lymphadenectomy of Laparoscopic Gastrectomy with D2 Lymph Node Dissection for Distal Gastric Cancer in 141 Cases

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