title: Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer in left approach: a new operation procedure.
abstract: BACKGROUND
  To explore the feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection in a left-sided approach for advanced proximal gastric cancer.
  
  
  METHODS
  The clinical data of 32 patients with advanced proximal gastric cancer who underwent laparoscopic spleen-preserving No. 10 lymph node dissection from June 2010 to December 2011 were analyzed.
  
  
  RESULTS
  Laparoscopic spleen-preserving No. 10 lymph node dissection using a left-sided approach was successfully performed for all patients without open conversion. The mean operation time was 206.4±54.3 minutes, mean intraoperative blood loss was 68.2±34.1 ml, mean number of No. 10 lymph nodes dissected was 2.8±2.1, mean number of positive No. 10 lymph nodes was 0.6±1.2, and the incidence of No. 10 lymph node metastasis was 11.6%. The mean postoperative hospital stay was 11.3±1.5 days. The postoperative morbidity rate was 9.4%, and there was no postoperative death. Splenic lobar vessels of all 32 patients were anatomically classified and divided into three types: 4 patients had a single lobar vessel, 22 had two lobar vessels and 6 had three lobar vessels.
  
  
  CONCLUSIONS
  Laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer using a left-sided approach is technically feasible. It simplifies the complicated surgical procedure of No. 10 lymph node dissection and leads to the popularization and promotion of this technique.
authors.affiliation: Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Jia-Bin
authors.forename: Huang
authors.initials: H
authors.lastname: Chang-Ming
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chao-Hui
authors.forename: Li
authors.initials: L
authors.lastname: Ping
authors.forename: Xie
authors.initials: X
authors.lastname: Jian-Wei
authors.forename: Lin
authors.initials: L
authors.lastname: Jian-Xian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000098:blood supply / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*