Comparison of the counts of station-specific lymph nodes retrieved in laparoscopy-assisted distal gastrectomy of early experience with those in open distal gastrectomy.

Background: The aim of this study is to compare the number of retrieved lymph nodes according to lymph node stations in laparoscopy-assisted distal gastrectomy (LADG) of the early experience of a new surgeon with that in open distal gastrectomy (ODG).
Materials and Methods: From May 2008 to August 2012, clinicopathologic data of gastric cancer patients subjected to LADG or ODG at a single institution by one surgeon were retrospectively reviewed. The surgeries were stratified as follows: early LADG (initial 30 LADGs), late LADG, and ODG. Station-specific counts of lymph nodes retrieved served for group comparisons.
Results: Gender distribution (male:female ratio) was not different among the three groups (early LADG, 16:14; late LADG, 19:4; and ODG, 38:30). Mean lymph node retrieval in the early and late LADG groups (39.1 and 45.6, respectively) fell significantly below that of the ODG group (53.0) (P<.001). Compared with the ODG group, fewer station-specific lymph nodes were retrieved via LADG, both early (stations 3, 8a, and 11p) and late (station 11p).
Conclusions: Surgeons inexperienced in LADG for gastric cancer should be particularly diligent in lymph node dissection at stations 3, 8a, and 11p. Even with more experience (>30 LADGs), lymph node dissection at station 11p merits special attention.