title: Laparoscopic splenic hilar lymphadenectomy for advanced gastric cancer.
abstract: Laparoscopic distal gastrectomy has recently become accepted as a surgical option for early gastric cancer in the distal stomach, but laparoscopic total gastrectomy (LTG) has not become widespread because of technical difficulties of esophagojejunal anastomosis and splenic hilar lymphadenectomy. Splenic hilar lymphadenectomy should be employed in the treatment of advanced proximal gastric cancer to complete D2 dissection, but laparoscopically it is technically difficult even for skilled surgeons. Based on the evidence that prophylactic combined resection of spleen in total gastrectomy increased the risk of postoperative morbidity with no survival impact, surgeons have preferred laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPL) for advanced tumors without metastasis to splenic hilar nodes or invasion to the greater curvature of the stomach, and reports with LSPL have been increasing rather than LTG with splenectomy. In this paper, recent reports with laparoscopic splenic hilar lymphadenectomy were reviewed.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Hosogi
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan;; Department of Surgery, Otsu Municipal Hospital, Shiga 520-0804, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okabe
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shinohara
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tsunoda
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hisamori
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
keywords: Laparoscopic total gastrectomy (LTG); advanced gastric cancer; spleen-preserving; splenectomy; splenic hilar lymphadenectomy