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Safety and feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection for locally advanced upper third gastric cancer: a prospective, multicenter clinical trial

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作者：
Chao-Hui Zheng[1] * ; Yan-Chang Xu[2] * ; Gang Zhao[3] * ; Li-Sheng Cai[4] * ; Guo-Xin Li[5] * ; Ze-Kuan Xu[6] ; Su Yan[7] ; Zu-Guang Wu[8] ; Fang-Qin Xue[9] ; Yi-Hong Sun[10] ; Dong-Bo Xu[11] ; Wen-Bin Zhang[12] ; Jin-Wan[13] ; Pei-Wu Yu[14] ; Jian-Kun Hu[15] ; Xiang-Qian Su[16] ; Jia-Fu Ji[16] ; Zi-Yu Li[16] ; Jun You[17] ; Yong Li[18] ; Lin-Fan[19] ; Jun-Lu[1] ; Ping-Li[1] ; Chang-Ming Huang[1] ; the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS)[CLASS] ;
机构： [1]Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian, China [2]Fujian Medicine University, Teaching Hospital, The First Hospital of PuTian City, Putian 351100, China [3]Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China [4]Department of General Surgery Unit 4, Zhangzhou Afliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian, China [5]Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China [6]Department of General Surgery, Jiangsu Province Hospital, Nanjing Medical University, Nanjing 210000, China [7]Department of Gastrointestinal Surgery, Afliated Hospital of Qinghai University, Qinghai Medical University, Xining 810000, China [8]Department of General Surgery Unit 2, Meizhou People’s Hospital of Guangdong, Meizhou 514021, China [9]Department of Gastrointestinal Surgery, Fujian Provincial Hospital, Fuzhou 350001, China [10]Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China [11]Department of General Surgery, Longyan First Hospital, Longyan 364000, China [12]Department of General Surgery, The First Afliated Hospital of Xinjiang Medical University, Xinjiang Medical University, Wulumuqi 830001, China [13]Department of General Surgery, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510515, China [14]Department of General Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China [15]Department of Gastrointestinal Surgery, West China [H]ospital of Sichuan University, Sichuan University, Chengdu 610000, China [16]Gastrointestinal Cancer Center, Beijing University Cancer Hospital, Beijing 100142, China [17]Department of Gastrointestinal Surgery, The First Afliated Hospital of Xiamen University, Xiamen University, Xiamen 361000, China [18]Department of Gastrointestinal Surgery, Guangdong General Hospital, Guangzhou 510515, China [19]Department of General Surgery, The First Afliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
出处：
DOI： 10.1007/s00464-019-07306-8
ISSN：

关键词： Gastric cancer Laparoscopy Prospective multicenter feasibility study Spleen-preserving total gastrectomy

摘要：
Background: Previous retrospective studies have shown that laparoscopic spleen-preserving D2 total gastrectomy (LSTG) for advanced upper third gastric cancer (AUTGC) is safe. However, all previous studies were underpowered. We therefore conducted a prospective, multicenter study to evaluate the technical safety and feasibility of LSTG for patients with AUTGC. Methods: Patients diagnosed with AUTGC (cT2-4a, N−/+, M0) underwent LSTG at 19 institutions between September 2016 and October 2017 were included. The number of No. 10 lymph node (LN) dissections, metastasis rates, intraoperative and postoperative complications were investigated. Results: A total of 251 patients were enrolled in the study, and 242 patients were eligible for the per protocol analysis. The average numbers of No. 10 LN dissections and metastases were 2.4 and 0.1, respectively. Eighteen patients (7.4%) had No. 10 LN metastases, and among patients with advanced gastric cancer, the rate of No. 10 LN metastasis was 8.1% (18/223). pN3 status was an independent risk factor for No. 10 LN metastasis. Intraoperative complications occurred in 7 patients, but no patients required conversion to open surgery or splenectomy. The overall postoperative complication rate was 13.6% (33/242). The major complication and mortality rates were 3.3% (8/242) and 0.4% (1/242), respectively. The number of retrieved No. 10 LNs, No. 10 LN metastasis and TNM stage had no significant influence on postoperative complication rates. Conclusion: LSTG for AUTGC was safe and effective when performed by very experienced surgeons, this technique could be used in patients who needed splenic hilar lymph node dissection. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

基金：
The study was sponsored by the Scientific and technological innovation joint capital projects of Fujian Province (2016Y9031, 2017Y9011); Construction Project of Fujian Province Minimally Invasive Medical Center (No.[2017]171); The second batch of special support funds for Fujian Province innovation and entrepreneurship talents (2016B013); Chinese physicians association young physician respiratory research fund of Fujian province medical innovation project (2015-CXB-16).
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外文
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出版当年[2019]版：
大类 | 3 区 医学
小类 | 2 区 外科
最新[2025]版：
大类 | 2 区 医学
小类 | 2 区 外科
JCR分区：
出版当年[2018]版：
Q1 SURGERY
最新[2023]版：
Q1 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

第一作者：
第一作者机构： [1]Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Chao-Hui Zheng,Yan-Chang Xu,Gang Zhao,et al.Safety and feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection for locally advanced upper third gastric cancer: a prospective, multicenter clinical trial[J].SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES.2020,34(11):5062-5073.doi:10.1007/s00464-019-07306-8.
APA：
Chao-Hui Zheng,Yan-Chang Xu,Gang Zhao,Li-Sheng Cai,Guo-Xin Li...&the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS).(2020).Safety and feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection for locally advanced upper third gastric cancer: a prospective, multicenter clinical trial.SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,34,(11)
MLA：
Chao-Hui Zheng,et al."Safety and feasibility of laparoscopic spleen-preserving No. 10 lymph node dissection for locally advanced upper third gastric cancer: a prospective, multicenter clinical trial".SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 34..11(2020):5062-5073

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