Possible role of lymph node dissection in the surgical treatment of gastric cancer with disseminating peritoneal metastasis

1983 ◽  
Vol 13 (5) ◽  
pp. 404-408 ◽  
Author(s):  
Nobuaki Kaibara ◽  
Tsuneyuki Okamoto ◽  
Osamu Kimura ◽  
Yasuo Iitsuka ◽  
Masataka Takebayashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Peritoneal Metastasis ◽  
Node Dissection

OPTIMIZATION OF SURGICAL TACTICS FOR TREATING PATIENTS WITH GASTRIC CANCER IN CASE OF VARIANT ANATOMY OF THE CELIAC-MESENTERIC BASIN

2019 ◽  
Vol 65 (4) ◽  
pp. 537-545
Author(s):  
Aleksandr Zakharenko ◽  
Kirill Vovin ◽  
Mikhail Belyaev ◽  
Anton Trushin ◽  
T. Kupenskaya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Comparison Group ◽  
Perioperative Complications ◽  
Treatment Algorithm ◽  
Main Group ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

Relevance: The variability of the visceral vessels occurs from 10 to 30%. There are anatomical options in which the main arteries of the stomach depart from the aorta or superior mesenteric artery. The recommended standardized surgical technique for radical treatment of gastric cancer is defined for typical vascular anatomy. Objective: To improve the results of surgical treatment of patients with gastric cancer (GC) by optimizing the diagnostic algorithm and correcting surgical techniques. Material and Methods: The results of surgical treatment of 296 patients with gastric cancer cT1-4N1-2M0, who were treated at I.P. Pavlov First St. Petersburg State Medical University from 2012-2017. In the main group of patients (n = 176), the proposed diagnostic and treatment algorithm was applied (spiral computed tomography in the angiographic mode (SCTA) + with the discharge of the vessel participating in the blood supply to the stomach from the aorta (AO) and / or the superior mesenteric artery (SMA) extended lymph node dissection D2 + № 16a2, № 16b1). All patients were radically operated. The evaluation of the diagnostic characteristics of SCTA was performed. The results of treatment were evaluated in 108 patients of the main group. The comparison group (n = 120) consisted of patients in whom vascular anatomy was not studied. Estimated blood loss, time of operation, the frequency of perioperative complications and long-term survival. Results: In 32,9 % (n = 58) patients, variant anatomy of the visceral vessels of the upper abdominal cavity was detected. Additional arteries with typical trifurcation were found in 21,6 % (n = 38) of cases; celiac trunk bifurcation was determined in 10,2 % (n = 18) of patients; the absence of the celiac trunk and a single celiac-mesenteric trunk were found in 1,1 % (n = 2) of patients. The sensitivity of SCTA was 95,7 %, specificity 94,4 %, total accuracy 95,4 %. As a result of the applied diagnostic and treatment algorithm, the standard volume of D2 lymph node dissection was performed in 124 (70,4 %) patients during the surgical treatment of the main group of patients. Expansion of lymphadenectomy to D2 + was required in 52 (29,5 %) patients. Metastases to lymph nodes of groups № 16a2 and № 16b1 in patients who underwent extended D2 + lymph node dissection were detected in 16 (30,8 %) cases. The average blood loss in the main group was 1,95 times less and amounted to 126,5±22 ml, and in the comparison group - 246,7±34 ml (M ± m, p = 0,0276). A comparison of the average duration of the operation did not show any significant differences: in the comparison group it was 188,2 ± 16,4 minutes, while the main group was slightly lower - 172,3 ± 21,5 minutes. In the main group, the total number of complications was 14 cases (13,5 %) and was significantly lower than in the comparison group - 29 cases (25,9 %). Survival for 1-2-3 years in patients of the main group was higher than the comparison group and amounted to 92,6, 75,0, 53,7 % and 90,8, 71,8, 47,5 %, respectively. The relapsefree 1-2-3-year survival of the group of patients to whom the diagnostic and treatment algorithm was applied was also higher than in the comparison group and amounted to 90,7, 73,1, 48,1 % and 90,8, 68, 3, 44,2 %, respectively. The median survival was significantly better in the main group of patients - 31,4 months, in the comparison group - 28,5 months. Conclusions: Performing SCTA at the preoperative stage is an effective way to visualize the great vessels, allowing to plan the volume of the operation, to avoid perioperative complications. Expanding the volume of lymph node dissection to D2 + № 16a2, № 16b1 when the vessel participating in the blood supply to the stomach from the AO and / or SMA is released, as it allows to improve the long-term results of treatment of patients with gastric cancer, by increasing radical surgery.

Does the extent of lymph node dissection affect the postoperative survival of patients with gastric cancer and disseminating peritoneal metastasis?

Surgery Today ◽  
1994 ◽  
Vol 24 (1) ◽  
pp. 40-43 ◽  
Author(s):  
Michio Maeta ◽  
Akira Sugesawa ◽  
Masahide Ikeguchi ◽  
Shunichi Tsujitani ◽  
Hiroshi Yamashiro ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Peritoneal Metastasis ◽  
Postoperative Survival ◽  
Node Dissection

scholarly journals Optimum extent of lymph node dissection in the surgical treatment of gastric cancer accompanied by liver cirrhosis.

1991 ◽  
Vol 24 (3) ◽  
pp. 798-804 ◽  
Author(s):  
Hiroshi Isozaki ◽  
Kunio Okajima ◽  
Yasuo Kawashima ◽  
Shinichi Yamada ◽  
Shinsho Morita ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Liver Cirrhosis ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Node Dissection

Is There Any Role of Additional Retropancreatic Lymph Node Dissection on D2 Gastrectomy for Advanced Gastric Cancer?

2013 ◽  
Vol 20 (8) ◽  
pp. 2669-2675 ◽  
Author(s):  
Bang Wool Eom ◽  
Jungnam Joo ◽  
Young-Woo Kim ◽  
Boram Park ◽  
Ji Yeon Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
D2 Gastrectomy
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