Inspection of Safety and Accuracy of D2 Lymph Node Dissection in Laparoscopy-Assisted Distal Gastrectomy
Background There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few med...
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| Published in | World journal of surgery Vol. 32; no. 11; pp. 2366 - 2370 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer-Verlag
01.11.2008
Springer‐Verlag Springer John Wiley & Sons, Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer.
Methods
The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements.
Results
No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 ± 126.3 ml) than in ODG (221.9 ± 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 ± 15.6) and LADG (49.2 ± 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 ± 5.6 days) than for ODG (21 ± 11.4 days).
Conclusions
D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. |
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| AbstractList | There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements. No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 ± 126.3 ml) than in ODG (221.9 ± 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 ± 15.6) and LADG (49.2 ± 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 ± 5.6 days) than for ODG (21 ± 11.4 days). D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. [PUBLICATION ABSTRACT] Background: There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. Methods: The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements. Results: No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 plus or minus 126.3 ml) than in ODG (221.9 plus or minus 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 plus or minus 15.6) and LADG (49.2 plus or minus 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 plus or minus 5.6 days) than for ODG (21 plus or minus 11.4 days). Conclusions: D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. Background There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. Methods The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements. Results No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 ± 126.3 ml) than in ODG (221.9 ± 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 ± 15.6) and LADG (49.2 ± 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 ± 5.6 days) than for ODG (21 ± 11.4 days). Conclusions D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer.BACKGROUNDThere is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer.The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements.METHODSThe study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements.No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 +/- 126.3 ml) than in ODG (221.9 +/- 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 +/- 15.6) and LADG (49.2 +/- 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 +/- 5.6 days) than for ODG (21 +/- 11.4 days).RESULTSNo significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 +/- 126.3 ml) than in ODG (221.9 +/- 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 +/- 15.6) and LADG (49.2 +/- 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 +/- 5.6 days) than for ODG (21 +/- 11.4 days).D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG.CONCLUSIONSD2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements. No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 +/- 126.3 ml) than in ODG (221.9 +/- 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 +/- 15.6) and LADG (49.2 +/- 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 +/- 5.6 days) than for ODG (21 +/- 11.4 days). D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. Background There is a consensus on the indication of laparoscopy‐assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. Methods The study population comprised 53 and 67 patients who underwent D2 dissection in LADG or ODG, respectively; with the diagnosis of preoperative depth grade SM, between 2004 and 2006. In D2 lymph node dissection, difficult points are dissections of lymph node along the superior mesenteric vein (No. 14v), along the hepatic artery (No. 12a), and along the proximal splenic artery (No. 11p). We performed these lymph nodes dissection in a fixed process, which was achieved through all improvements. Results No significant difference was observed in age, sex, American Society of Anesthesiology (ASA) classification, body mass index (BMI), and operative time between two groups. Bleeding volume was significantly lower in LADG (96.5 ± 126.3 ml) than in ODG (221.9 ± 174.8 ml). There was no significant difference in number of dissected lymph nodes between ODG (44.8 ± 15.6) and LADG (49.2 ± 16.1), with no significant difference in degree of pathological stage. The postoperative complication rate was 16.4% for ODG and 5.7% for LADG, and postoperative hospital stay was significantly shorter for LADG (16.7 ± 5.6 days) than for ODG (21 ± 11.4 days). Conclusions D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG. |
| Author | Homma, Shigenori Watarai, Hiroshi Hagiwara, Masaru Kondo, Yukifumi Sato, Masanori Ueki, Shinya Yokota, Kentaro Yokota, Ryoichi Kawamura, Hideki Noguchi, Keita |
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| Issue | 11 |
| Keywords | Gastric Cancer Early Gastric Cancer Advanced Gastric Cancer Open Gastrectomy Superior Mesenteric Vein Toxicity Lymph node clearance Inspection Laparoscopy Gastrectomy Medicine Lymphadenectomy Accuracy Treatment Surgery Distal Endoscopy Safety |
| Language | English |
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| PublicationSubtitle | Official Journal of the International Society of Surgery/Société Internationale de Chirurgie |
| PublicationTitle | World journal of surgery |
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| PublicationYear | 2008 |
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| References | Kitano, Iso, Moriyama (CR3) 1994; 4 Adachi, Shiraishi, Shiromizu (CR12) 2000; 135 CR2 Lee, Kim, Ryu (CR10) 2007; 14 Song, Kim, Park (CR11) 2008; 22 Tanimura, Higashino, Fukumaga (CR8) 2005; 19 Asao, Hosouchi, Nakabayashi (CR4) 2001; 88 Hiki, Shimoyama, Yamaguchi (CR5) 2006; 203 Noshiro, Nagai, Shimizu (CR9) 2005; 19 Tanimura, Higashino, Fukunaga (CR7) 2003; 6 Shiraishi, Yasuda, Kitano (CR13) 2006; 9 Kitagawa, Kitano, Kubota (CR16) 2005; 8 Tanimura, Higashino, Fukunaga (CR6) 2001; 11 Huscher, Mingoli, Sgarzini (CR15) 2005; 241 (CR1) 2006; 5 Kitano, Yasuda, Shiraishi (CR14) 2006; 18 2005; 19 2005; 241 2000; 135 2003; 6 2005; 8 2006; 9 2006; 5 2006; 18 2008; 22 1998; 1 2001; 88 2001; 11 2006; 203 1994; 4 2007; 14 e_1_2_5_14_2 e_1_2_5_13_2 e_1_2_5_9_2 e_1_2_5_16_2 Kitano S (e_1_2_5_4_2) 1994; 4 e_1_2_5_8_2 e_1_2_5_15_2 e_1_2_5_7_2 e_1_2_5_10_2 e_1_2_5_6_2 e_1_2_5_5_2 e_1_2_5_12_2 e_1_2_5_11_2 e_1_2_5_3_2 Japanese Society for Endoscopic Surgery (e_1_2_5_2_2) 2006; 5 e_1_2_5_17_2 10896374 - Arch Surg. 2000 Jul;135(7):806-10 15864717 - Gastric Cancer. 2005;8(2):103-10 11444743 - Surg Laparosc Endosc Percutan Tech. 2001 Jun;11(3):155-60 11136325 - Br J Surg. 2001 Jan;88(1):128-32 17593447 - Surg Endosc. 2008 Mar;22(3):655-9 16864028 - J Am Coll Surg. 2006 Aug;203(2):162-9 17705092 - Ann Surg Oncol. 2007 Nov;14(11):3148-53 15650632 - Ann Surg. 2005 Feb;241(2):232-7 16132317 - Surg Endosc. 2005 Sep;19(9):1177-81 8180768 - Surg Laparosc Endosc. 1994 Apr;4(2):146-8 16247578 - Surg Endosc. 2005 Dec;19(12):1592-6 16825901 - Eur J Gastroenterol Hepatol. 2006 Aug;18(8):855-61 11957040 - Gastric Cancer. 1998 Dec;1(1):10-24 12673429 - Gastric Cancer. 2003;6(1):64-8 16952034 - Gastric Cancer. 2006;9(3):167-76 19225833 - World J Surg. 2009 Jul;33(7):1542-3; author reply 1544 |
| References_xml | – volume: 9 start-page: 167 year: 2006 end-page: 176 ident: CR13 article-title: Laparoscopic gastrectomy with lymph node dissection for gastric cancer publication-title: Gastric Cancer doi: 10.1007/s10120-006-0380-9 – volume: 88 start-page: 128 year: 2001 end-page: 132 ident: CR4 article-title: Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer publication-title: Br J Surg doi: 10.1046/j.1365-2168.2001.01618.x – volume: 6 start-page: 64 year: 2003 end-page: 68 ident: CR7 article-title: Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer publication-title: Gastric Cancer doi: 10.1007/s101200300009 – volume: 22 start-page: 655 year: 2008 end-page: 659 ident: CR11 article-title: Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects publication-title: Surg Endosc doi: 10.1007/s00464-007-9431-5 – volume: 8 start-page: 103 year: 2005 end-page: 110 ident: CR16 article-title: Minimally invasive surgery for gastric cancer—toward a confluence of two major streams: a review publication-title: Gastric Cancer doi: 10.1007/s10120-005-0326-7 – ident: CR2 – volume: 5 start-page: 528 year: 2006 end-page: 628 ident: CR1 article-title: The 8th questionnaire survey of endoscopic surgery publication-title: J Jpn Soc Endosc Surg – volume: 4 start-page: 146 year: 1994 end-page: 148 ident: CR3 article-title: Laparoscopy-assisted Billroth I gastrectomy publication-title: Surg Laparosc Endosc – volume: 14 start-page: 3148 year: 2007 end-page: 3153 ident: CR10 article-title: A phase II clinical trial of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients publication-title: Ann Surg Oncol doi: 10.1245/s10434-007-9446-0 – volume: 18 start-page: 855 year: 2006 end-page: 861 ident: CR14 article-title: Laparoscopic surgical resection for early gastric cancer publication-title: Eur J Gastroenterol Hepatol doi: 10.1097/00042737-200608000-00008 – volume: 11 start-page: 155 year: 2001 end-page: 160 ident: CR6 article-title: Hand-assisted laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer publication-title: Surg Endosc Percutan Tech doi: 10.1097/00019509-200106000-00001 – volume: 135 start-page: 806 year: 2000 end-page: 810 ident: CR12 article-title: Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy publication-title: Arch Surg doi: 10.1001/archsurg.135.7.806 – volume: 241 start-page: 232 year: 2005 end-page: 237 ident: CR15 article-title: Laparoscopic versus open subtotal gastrectomy for distal gastric cancer. Five-year results of a randomized prospective trial publication-title: Ann Surg doi: 10.1097/01.sla.0000151892.35922.f2 – volume: 19 start-page: 1177 year: 2005 end-page: 1181 ident: CR8 article-title: Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer publication-title: Surg Endosc doi: 10.1007/s00464-004-8936-4 – volume: 19 start-page: 1592 year: 2005 end-page: 1596 ident: CR9 article-title: Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer publication-title: Surg Endosc doi: 10.1007/s00464-005-0175-9 – volume: 203 start-page: 162 year: 2006 end-page: 169 ident: CR5 article-title: Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation publication-title: J Am Coll Surg doi: 10.1016/j.jamcollsurg.2006.05.003 – volume: 14 start-page: 3148 year: 2007 end-page: 3153 article-title: A phase II clinical trial of laparoscopy‐assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients publication-title: Ann Surg Oncol – volume: 19 start-page: 1177 year: 2005 end-page: 1181 article-title: Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer publication-title: Surg Endosc – volume: 19 start-page: 1592 year: 2005 end-page: 1596 article-title: Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer publication-title: Surg Endosc – volume: 1 start-page: 10 year: 1998 end-page: 24 article-title: Japanese classification of gastric carcinoma, 2nd English edn publication-title: Gastric Cancer – volume: 11 start-page: 155 year: 2001 end-page: 160 article-title: Hand‐assisted laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer publication-title: Surg Endosc Percutan Tech – volume: 203 start-page: 162 year: 2006 end-page: 169 article-title: Laparoscopy‐assisted pylorus‐preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation publication-title: J Am Coll Surg – volume: 4 start-page: 146 year: 1994 end-page: 148 article-title: Laparoscopy‐assisted Billroth I gastrectomy publication-title: Surg Laparosc Endosc – volume: 88 start-page: 128 year: 2001 end-page: 132 article-title: Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer publication-title: Br J Surg – volume: 5 start-page: 528 year: 2006 end-page: 628 article-title: The 8th questionnaire survey of endoscopic surgery publication-title: J Jpn Soc Endosc Surg – volume: 241 start-page: 232 year: 2005 end-page: 237 article-title: Laparoscopic versus open subtotal gastrectomy for distal gastric cancer. Five‐year results of a randomized prospective trial publication-title: Ann Surg – volume: 9 start-page: 167 year: 2006 end-page: 176 article-title: Laparoscopic gastrectomy with lymph node dissection for gastric cancer publication-title: Gastric Cancer – volume: 8 start-page: 103 year: 2005 end-page: 110 article-title: Minimally invasive surgery for gastric cancerߝtoward a confluence of two major streams: a review publication-title: Gastric Cancer – volume: 6 start-page: 64 year: 2003 end-page: 68 article-title: Laparoscopic gastrectomy with regional lymph node dissection for upper gastric cancer publication-title: Gastric Cancer – volume: 18 start-page: 855 year: 2006 end-page: 861 article-title: Laparoscopic surgical resection for early gastric cancer publication-title: Eur J Gastroenterol Hepatol – volume: 135 start-page: 806 year: 2000 end-page: 810 article-title: Laparoscopy‐assisted Billroth I gastrectomy compared with conventional open gastrectomy publication-title: Arch Surg – volume: 22 start-page: 655 year: 2008 end-page: 659 article-title: Laparoscopy‐assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects publication-title: Surg Endosc – ident: e_1_2_5_3_2 doi: 10.1007/PL00011681 – ident: e_1_2_5_7_2 doi: 10.1097/00019509‐200106000‐00001 – ident: e_1_2_5_13_2 doi: 10.1001/archsurg.135.7.806 – ident: e_1_2_5_17_2 doi: 10.1007/s10120‐005‐0326‐7 – ident: e_1_2_5_6_2 doi: 10.1016/j.jamcollsurg.2006.05.003 – ident: e_1_2_5_10_2 doi: 10.1007/s00464‐005‐0175‐9 – ident: e_1_2_5_12_2 doi: 10.1007/s00464‐007‐9431‐5 – volume: 4 start-page: 146 year: 1994 ident: e_1_2_5_4_2 article-title: Laparoscopy‐assisted Billroth I gastrectomy publication-title: Surg Laparosc Endosc – ident: e_1_2_5_15_2 doi: 10.1097/00042737‐200608000‐00008 – ident: e_1_2_5_5_2 doi: 10.1046/j.1365‐2168.2001.01618.x – ident: e_1_2_5_14_2 doi: 10.1007/s10120‐006‐0380‐9 – ident: e_1_2_5_16_2 doi: 10.1097/01.sla.0000151892.35922.f2 – ident: e_1_2_5_8_2 doi: 10.1007/s101200300009 – ident: e_1_2_5_9_2 doi: 10.1007/s00464‐004‐8936‐4 – volume: 5 start-page: 528 year: 2006 ident: e_1_2_5_2_2 article-title: The 8th questionnaire survey of endoscopic surgery publication-title: J Jpn Soc Endosc Surg – ident: e_1_2_5_11_2 doi: 10.1245/s10434‐007‐9446‐0 – reference: 16825901 - Eur J Gastroenterol Hepatol. 2006 Aug;18(8):855-61 – reference: 15650632 - Ann Surg. 2005 Feb;241(2):232-7 – reference: 19225833 - World J Surg. 2009 Jul;33(7):1542-3; author reply 1544 – reference: 16132317 - Surg Endosc. 2005 Sep;19(9):1177-81 – reference: 11136325 - Br J Surg. 2001 Jan;88(1):128-32 – reference: 11444743 - Surg Laparosc Endosc Percutan Tech. 2001 Jun;11(3):155-60 – reference: 8180768 - Surg Laparosc Endosc. 1994 Apr;4(2):146-8 – reference: 10896374 - Arch Surg. 2000 Jul;135(7):806-10 – reference: 11957040 - Gastric Cancer. 1998 Dec;1(1):10-24 – reference: 15864717 - Gastric Cancer. 2005;8(2):103-10 – reference: 16247578 - Surg Endosc. 2005 Dec;19(12):1592-6 – reference: 12673429 - Gastric Cancer. 2003;6(1):64-8 – reference: 17593447 - Surg Endosc. 2008 Mar;22(3):655-9 – reference: 16864028 - J Am Coll Surg. 2006 Aug;203(2):162-9 – reference: 17705092 - Ann Surg Oncol. 2007 Nov;14(11):3148-53 – reference: 16952034 - Gastric Cancer. 2006;9(3):167-76 |
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There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph... Background There is a consensus on the indication of laparoscopy‐assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph... There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node... There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + α or D1 + β lymph node... Background: There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 +... |
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| SubjectTerms | Abdominal Surgery Advanced Gastric Cancer Aged Biological and medical sciences Cardiac Surgery Cohort Studies Digestive system. Abdomen Early Gastric Cancer Endoscopy Female Gastrectomy Gastric Cancer General aspects General Surgery Humans Investigative techniques, diagnostic techniques (general aspects) Laparoscopy Lymph Node Excision - adverse effects Lymph Node Excision - methods Male Medical sciences Medicine Medicine & Public Health Middle Aged Neoplasm Staging Open Gastrectomy Reproducibility of Results Retrospective Studies Stomach Neoplasms - pathology Stomach Neoplasms - surgery Superior Mesenteric Vein Surgery Thoracic Surgery Treatment Outcome Vascular Surgery |
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| Title | Inspection of Safety and Accuracy of D2 Lymph Node Dissection in Laparoscopy-Assisted Distal Gastrectomy |
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