title: Laparoscopic Suprapancreatic Lymph Node Dissection for Advanced Gastric Cancer Using a Left-Sided Approach.
abstract: BACKGROUND
  We developed a novel procedure for laparoscopic suprapancreatic lymph node (LN) dissection, which is compulsory and quite difficult for patients with advanced gastric cancer.1 (-) 3 METHODS: We dissected suprapancreatic LNs from the left to the right side. The No. 11p LNs were dissected first, followed by the No. 9, 7, and 8a LNs. Dissection of the No. 5 and 12a LNs was completed last. The above procedure was performed on 814 consecutive patients with stage cT2-3 disease.
  
  
  RESULTS
  Mean operation time was 186.9 ± 56.4 min (range 80-480 min), mean blood loss was 76.6 ± 106.8 ml (range 3-500 ml), and mean times to first flatus, fluid diet, and soft diet were 3.7 ± 1.2 days (range 1-9 days), 5.2 ± 1.7 days (range 2-14 days), and 8.3 ± 2.2 days (range 5-20 days), respectively. A mean 34.5 ± 12.9 LNs (range 22-103) were retrieved, including a mean 12.4 ± 5.7 (range 0-35) suprapancreatic area LNs. Overall postoperative morbidity rate was 14.7 % (120/814), including three cases of pancreatic fistula. All of these postoperative complications were successfully treated by conservative methods. At a median follow-up of 27 months (range 1-63), cumulative 3-year overall survival was 59.2 %.
  
  
  CONCLUSIONS
  Laparoscopic suprapancreatic LN dissection using a left-sided approach could be safely achieved and is more convenient for advanced gastric cancer.
authors.affiliation: Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China, hcmlr2002@163.com.
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Huang
authors.forename: Qi-Yue
authors.initials: QY
authors.lastname: Chen
authors.forename: Jian-Xian
authors.initials: JX
authors.lastname: Lin
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Zheng
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Xie
authors.forename: Jia-Bin
authors.initials: JB
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.forename: Xin-Tao
authors.initials: XT
authors.lastname: Yang
mesh_terms: D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D061646:Operative Time; D010179:Pancreas / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*