title: [Efficacy comparison of lymph node dissection patterns of the reverse and the cabbage in hand-assisted laparoscopic D2 radical gastrectomy].
abstract: OBJECTIVE
  To compare the clinical efficacy of the lymph node dissection patterns of the reverse and the traditional cabbage in hand-assisted laparoscopic D2 radical gastrectomy (HALG).
  
  
  METHODS
  From December 2010 to October 2013, 194 patients with HALG in Chengdu Military General Hospital were enrolled in this study. According to the pattern of lymph node dissection, 108 patients were performed with the reverse procedure which took spleen as starting point, from left to right, and 86 patients were performed with the traditional cabbage procedure which took the abdominal cavity as the center, from both sides to middle. A retrospective comparative analysis was made on the intra- and post-operative data between the two groups.
  
  
  RESULTS
  All the patients were successfully performed with HALG, and no peri-operative death occurred. There were no significant differences in the incision length [(7.0 ± 0.2) cm vs. (6.9 ± 0.3) cm], the operative time [(170.9 ± 33.8) minute vs. (174.6 ± 22.4) minute], dissected lymph node number (17.6 ± 7.5 vs. 17.1 ± 5.8) and post-operative complications [(6.5%(7/108) vs. 8.1%(7/86)] between the reverse group and cabbage group (all P>0.05). However, less blood loss [(204.6 ± 98.2) ml vs. (259.1 ± 122.6) ml, P<0.01] and shorter postoperative hospital stay [(9.0 ± 1.7) day vs. (10.5 ± 4.0) day, P<0.01] were observed in reverse group as compared to cabbage group. During 1 to 6 months follow-up, no death case was found in reverse group, while 1 case died due to upper gastrointestinal bleeding 48 days after operation in cabbage group.
  
  
  CONCLUSIONS
  Efficacy is similar between the two HALG procedures in lymph node dissection, while reverse procedure has certain advantages, such as less blood loss and faster recovery.
authors.affiliation: Gastrointestinal Ward of The PLA General Surgery Centre, Chengdu Military General Hospital, Chengdu 610083, China. caoyok@163.com.
authors.forename: Yongkuan
authors.initials: Y
authors.lastname: Cao
authors.forename: Jiaqing
authors.initials: J
authors.lastname: Gong
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.forename: Liye
authors.initials: L
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Gan
authors.forename: Ling
authors.initials: L
authors.lastname: Huang
authors.forename: Guohu
authors.initials: G
authors.lastname: Zhang
authors.forename: Peihong
authors.initials: P
authors.lastname: Wang
authors.forename: Gude
authors.initials: G
authors.lastname: Luo
authors.forename: Yaning
authors.initials: Y
authors.lastname: Song
mesh_terms: D005743:Gastrectomy / Q000379:methods*; D058733:Hand-Assisted Laparoscopy; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*