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Upper lesser curvature skeletonization in radical distal gastrectomy.
- Source :
-
The Journal of surgical research [J Surg Res] 2015 Jan; Vol. 193 (1), pp. 168-75. Date of Electronic Publication: 2014 Jul 22. - Publication Year :
- 2015
-
Abstract
- Background: To investigate the metastatic status of lymph nodes numbers (no.) 1, 3a, and 3b groups in radical distal gastrectomy with upper lesser curvature skeletonization and the risk factors for lesser curvature regional node (LCRN) metastasis.<br />Methods: Data on patients who underwent radical distal gastrectomy were retrospectively collected between May 2010 and September 2013. Clinicopathologic features and surgical outcomes were compared between the LCRN (+) and (-) groups. The correlations among the no. 1, 3a and 3b groups, and other groups were analyzed. Univariate and multivariate analyses were performed to identify the independent risk factors for LCRN metastasis.<br />Results: A total of 112 patients were analyzed. In all, 45.5% had metastatic LCRNs, and 59.8% were node positive overall. The LCRN (+) and (-) groups had significantly different features, including gender; tumor size; histologic grade; Lauren classification; gross type; and T, N, and TNM stages. The positivity rates of the no. 1, 3a, and 3b groups were 4.5%, 38.4%, and 32.1%, respectively, and the no. 1, 3a, and 3b groups were comprehensively correlated with the D2-tier groups. In the univariate and multivariate analyses, only stage T3-4 and positive no. 4d nodes were documented as independent risk factors, whereas no. 5 and 11p nodes trended toward a positive correlation.<br />Conclusions: LCRNs have high frequencies of metastasis in lower gastric cancers, and in the present study, these groups of lymph nodes tended to be associated with each other as an entity in the lesser curvature region. Upper lesser curvature skeletonization can be recommended as a standard procedure in radical distal gastrectomy to thoroughly clear the gastric stump, especially in the case of stage T3-4 or suspicious no. 4d nodes.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Female
Gastrectomy mortality
Humans
Logistic Models
Lymph Node Excision mortality
Lymph Nodes pathology
Lymph Nodes surgery
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neoplasm Grading
Retrospective Studies
Risk Factors
Stomach surgery
Stomach Neoplasms mortality
Gastrectomy statistics & numerical data
Lymph Node Excision statistics & numerical data
Stomach Neoplasms secondary
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 193
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 25145906
- Full Text :
- https://doi.org/10.1016/j.jss.2014.07.035