Laparoscopic Surgery for Gastric Cancer, Total Gastrectomy with D2 Lymph Node Dissection
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For advanced gastric cancer located in the upper body of the stomach, total gastrectomy with D2 lymph node dissection is recommended [1–4]. D2 lymph node dissection for proximal tumors requires the retrieval of the soft tissues around distal portions of the splenic vessels and splenic hilum, which contain lymph nodes at stations #10 and #11d [4, 5]. Two options – a total gastrectomy with splenectomy and a spleen-preserving total gastrectomy – exist for retrieval of lymph nodes at station #10. While splenectomy-related postoperative complications, such as subphrenic abscess and postsplenectomy syndrome, are well known, complete lymph node dissection of the splenic hilum during spleen-preserving total gastrectomy is a very complex procedure.
This work was not supported by external or grant funding. None of the authors have commercial associations or financial involvement that pose a conflict of interest in connection with the submitted article.
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