title: [Analysis of lymph node dissection patterns in D2 radical gastrectomy by hand-assisted laparoscopic technique].
abstract: OBJECTIVE
  To summarize the experience of lymph node dissection patterns in hand-assisted laparoscopic radical gastrectomy.
  
  
  METHODS
  One hundred and eleven patients with gastric carcinoma between December 2010 and September 2012 were operated by hand-assisted laparoscopic system designed by us. Clinical data were analyzed retrospectively. The lymph nodes were dissected from left to right together with total tumor resection(reverse lymph nodes scavenge pattern), then digestive tract was reconstructed.
  
  
  RESULTS
  Total gastrectomy, distal gastrectomy and proximal gastrectomy were performed in 57, 46 and 8 cases respectively. Combined cholecystectomy and lateral segment of left liver lobe were needed in 4 and 2 patients respectively, and 1 case underwent combined splenectomy and pancreatic body and tail resection. TNM staging of patients in I(, II(, III(A, III(B, and IIII( were 16, 8, 35, 14, and 38, respectively. Histological type was poorly differentiated in 78 cases, moderate differentiation in 26 cases and good differentiation in 7 cases. The incision length was(6.8±0.3) cm, blood loss was(238.4±113.6) ml, operative time was (171.9±23.3) min, number of removed lymph node was 17.2±5.7, hospital stay was (10.1±3.7) d, postoperative complication rate was 9.0%. One case died during perioperative time.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic D2 radical gastrectomy(reverse lymph nodes scavenge pattern) can avoid the multiple conversion of open-laparoscopic operation model, and is beneficial to the standardization for surgical procedure.
authors.affiliation: Gastrointestinal Ward of PLA General Surgery Centre, General Hospital of Chengdu Military Command, Chengdu 610083, China. caoyok@163.com.
authors.forename: Yong-kuan
authors.initials: YK
authors.lastname: Cao
authors.forename: Li-ye
authors.initials: LY
authors.lastname: Liu
authors.forename: Jia-qing
authors.initials: JQ
authors.lastname: Gong
authors.forename: Yong-hua
authors.initials: YH
authors.lastname: Wang
authors.forename: Guo-de
authors.initials: GD
authors.lastname: Luo
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Gan
authors.forename: Ling
authors.initials: L
authors.lastname: Huang
mesh_terms: D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008198:Lymph Nodes; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*