Comparison of approaches and safety of laparoscopic splenic hilar lymph node dissection for the treatment of gastric cancer

Abstract

Objective To investigate the approaches of laparoscopic splenic hilar lymph node dissection for the treatment of gastric cancer and to compare their safety. Methods The clinical data of 71 patients with gastric cancer who underwent laparoscopic splenic hilar lymph node dissection in our hospital from January 2015 to January 2018 were retrospectively analyzed. According to the surgical approach, 39 cases were divided into left side approach group, 32 patients were divided into retrograde pancreatic approach group, the surgical indicators, complications rate, and postoperative quality of life scores were analyzed and compared. Data analysis was performed by statistical software SPSS22.0. Surgery-related indicators and quality of life scores at 6 months after surgery were expressed as (±s), and compared by the independent t test. The complication rate was compared by four-segment χ2 test. P<0.05 was considered statistically significant. Results The operative time, intraoperative blood loss, and anal exhaustion time in the left side approach group were all shorter than those in the retrograde pancreatic approach group (all P 0.05). There was no significant difference in the scores of quality of life for the 6 months after operation between the two groups (all P>0.05). Conclusions The complication rate and quality of life scores for the treatment of gastric cancer with laparoscopic hilar splenic lymph node dissection in the left approach and the posterior approach are all comparable, but the number of lymph nodes in the left approach is much more, and the operation time and intraoperative bleeding, and postoperative recovery time are shorter, the effect of surgery is better, and it is worthy of popularization and application. Key words: Stomach neoplasms; Laparoscopy; Quality of life; Comparative effectiveness research