Learning Curve of Laparoscopy Spleen-Preserving Splenic Hilar Lymph Node Dissection for Advanced Upper Gastric Cancer

Abstract

To investigate the learning curve of laparoscopy spleen-preserving splenic hilar lymph node dissection for advanced upper gastric cancer (AUGC). A retrospective analysis of clinical data of 100 cases of spleen-preserving splenic hilar lymph node dissection for AUGC, completed by the same group of physicians with extensive laparoscopic gastric cancer surgical experience. The patients were divided into five groups (A, B, C, D and E) in accordance with their surgical priorities. The five groups of patients were comparable in age, gender, body mass index, spleen lobe artery count, histological type and invasion department. The surgical time for Group A and Group B was longer than Group C, Group D and Group E. The amount of bleeding for Group A and Group B was significantly larger than Group C, Group D and Group E. Laparotomy rate, the number of splenic hilar lymph node dissection, incidence of complications, recovery time of bowel function, days for postoperative hospital stay were not statistically different among the five groups. On the basis of skilled surgical techniques for laparoscopic gastric cancer, the learning curve for laparoscopy spleen-preserving splenic hilar lymph node dissection for upper advanced gastric cancer was roughly 40 cases.