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Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector
BACKGROUND: Gastric cancer is one of the most common malignancies and is a leading cause of cancer death worldwide. Surgery is the most effective and successful method of treatment for gastric cancer, and systematic lymph node (LN) dissection is unquestionably the most effective procedure for treati...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223739/ https://www.ncbi.nlm.nih.gov/pubmed/25344327 http://dx.doi.org/10.1186/1477-7819-12-322 |
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author | Wu, Wenguang Dong, Ping Wu, Xiangsong Li, Maolan Ding, Qichen Zhang, Lin Yang, Jiahua Weng, Hao Ding, Qian Tan, Zhujun Lu, Jianhua Gu, Jun Liu, Yingbin |
author_facet | Wu, Wenguang Dong, Ping Wu, Xiangsong Li, Maolan Ding, Qichen Zhang, Lin Yang, Jiahua Weng, Hao Ding, Qian Tan, Zhujun Lu, Jianhua Gu, Jun Liu, Yingbin |
author_sort | Wu, Wenguang |
collection | PubMed |
description | BACKGROUND: Gastric cancer is one of the most common malignancies and is a leading cause of cancer death worldwide. Surgery is the most effective and successful method of treatment for gastric cancer, and systematic lymph node (LN) dissection is unquestionably the most effective procedure for treating LN metastases of gastric cancer. Systematic lymphadenectomy is the most important part of curative resection, but lymphadenectomy is also the most difficult procedure in gastric cancer surgery. The aim of this study is to report our three-step method for lymphadenectomy in gastric cancer. METHODS: In this study, the lymph node stations and groups were defined according to the 13th edition of the Japanese Classification for Gastric Carcinoma. The authors’ novel, simplified method consists of three steps: (1) the Kocher maneuver and dissection of the greater omentum together with the anterior sheet of the mesocolon, (2) dissection of the lesser omentum, and (3) lymphadenectomy following the main vessels. We primarily used Peng’s multifunctional operative dissector, which combines four different functions (cutting, separating, aspirating and coagulating). Our systematic lymphadenectomy included three steps, and the main procedure started from right to left and in the caudal to cranial direction. RESULTS: A total of 830 consecutive patients underwent our three-step-method systematic lymphadenectomy in advanced gastric cancer surgery. The mean operation time was 146 minutes, and the mean blood loss was 248 ml. The median postoperative hospital stay was 10.9 ± 4.8 days. The median number of examined LN was 31.6 (range 17 to 72) per patient, and the median number of metastatic LN was 5.6 (range 0 to 42) per patient. The overall incidence of postoperative complications was 10.6%, and the rate of hospital death was 0.9%. The overall three-year survival rate was 52.6%. CONCLUSIONS: Our three-step method for lymphadenectomy is easy to perform and is a useful procedure for gastric cancer surgery. |
format | Online Article Text |
id | pubmed-4223739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42237392014-11-08 Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector Wu, Wenguang Dong, Ping Wu, Xiangsong Li, Maolan Ding, Qichen Zhang, Lin Yang, Jiahua Weng, Hao Ding, Qian Tan, Zhujun Lu, Jianhua Gu, Jun Liu, Yingbin World J Surg Oncol Technical Innovations BACKGROUND: Gastric cancer is one of the most common malignancies and is a leading cause of cancer death worldwide. Surgery is the most effective and successful method of treatment for gastric cancer, and systematic lymph node (LN) dissection is unquestionably the most effective procedure for treating LN metastases of gastric cancer. Systematic lymphadenectomy is the most important part of curative resection, but lymphadenectomy is also the most difficult procedure in gastric cancer surgery. The aim of this study is to report our three-step method for lymphadenectomy in gastric cancer. METHODS: In this study, the lymph node stations and groups were defined according to the 13th edition of the Japanese Classification for Gastric Carcinoma. The authors’ novel, simplified method consists of three steps: (1) the Kocher maneuver and dissection of the greater omentum together with the anterior sheet of the mesocolon, (2) dissection of the lesser omentum, and (3) lymphadenectomy following the main vessels. We primarily used Peng’s multifunctional operative dissector, which combines four different functions (cutting, separating, aspirating and coagulating). Our systematic lymphadenectomy included three steps, and the main procedure started from right to left and in the caudal to cranial direction. RESULTS: A total of 830 consecutive patients underwent our three-step-method systematic lymphadenectomy in advanced gastric cancer surgery. The mean operation time was 146 minutes, and the mean blood loss was 248 ml. The median postoperative hospital stay was 10.9 ± 4.8 days. The median number of examined LN was 31.6 (range 17 to 72) per patient, and the median number of metastatic LN was 5.6 (range 0 to 42) per patient. The overall incidence of postoperative complications was 10.6%, and the rate of hospital death was 0.9%. The overall three-year survival rate was 52.6%. CONCLUSIONS: Our three-step method for lymphadenectomy is easy to perform and is a useful procedure for gastric cancer surgery. BioMed Central 2014-10-24 /pmc/articles/PMC4223739/ /pubmed/25344327 http://dx.doi.org/10.1186/1477-7819-12-322 Text en © Wu et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Technical Innovations Wu, Wenguang Dong, Ping Wu, Xiangsong Li, Maolan Ding, Qichen Zhang, Lin Yang, Jiahua Weng, Hao Ding, Qian Tan, Zhujun Lu, Jianhua Gu, Jun Liu, Yingbin Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title | Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title_full | Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title_fullStr | Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title_full_unstemmed | Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title_short | Three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with Peng’s multifunctional operative dissector |
title_sort | three-step method for systematic lymphadenectomy in gastric cancer surgery using the ‘curettage and aspiration dissection technique’ with peng’s multifunctional operative dissector |
topic | Technical Innovations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223739/ https://www.ncbi.nlm.nih.gov/pubmed/25344327 http://dx.doi.org/10.1186/1477-7819-12-322 |
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