title: Laparoscopic Spleen-Preserving Splenic Hilar Lymph Node Dissection for Advanced Upper Gastric Cancer in Patients with High Body Mass Index.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of laparoscopic spleen-preserving splenic hilar lymph node dissection for advanced upper gastric cancer in patients with high body mass index.
  
  
  METHODS
  Outcomes were retrospectively analyzed in 140 patients with AUGC who underwent laparoscopic spleen-preserving splenic hilar LN dissection between January 2010 and December 2012, including those with high (≥ 23 kg/m) and normal (< 23 kg/m2) BMI.
  
  
  RESULTS
  Except for BMI, the clinicopathologic characteristics of patients with high and normal BMI were similar. The number of retrieved No. 10 LNs per patient was significantly lower in the high than in the normal BMI group. There were no significant between group differences in operation time, blood loss, postoperative hospital stay and complications. Subgroup analysis showed that the numbers of No. 10 LNs retrieved per patient were lower in males with high than normal BMI and in patients after the initial learning curve of 40 patients with high than normal BMI.
  
  
  CONCLUSIONS
  Laparoscopic spleen-preserving splenic hilar LN dissection is feasible and safe in patients with high BMI, although even experienced laparoscopic surgeons should take special care in these patients, especially in men.
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Jia-Bin
authors.initials: JB
authors.lastname: Wang
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: Jian-Xian
authors.initials: JX
authors.lastname: Lin
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002983:Clinical Competence; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D059032:Learning Curve; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D059351:Organ Sparing Treatments / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013154:Spleen; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome