The current status and controversy of splenic hilar lymph node dissection for proximal gastric cancer with radical gastrectomy

Abstract

Lymphadenectomy is critical for radical gastrectomy with D2 lymph node dissection, which is especially correlated with the prognosis of patients. From laparotomy total gastrectomy combined with splenectomy to laparoscopic spleen-preserving splenic hilar lymph node dissection, the difficulty of radical gastrectomy for the advanced proximal gastric cancer is station 10 lymph node dissection all the time. Although researches have confirmed that dissection of splenic hilar lymph node for proximal gastric cancer could showed good curative effect in the short term, which is lack of support of Evidence-Based Medicine, cleaning the splenic hilar lymph node without rigorously plan could cause more damage to the patients, even irreversible complications owing to the anatomical complexity. For splenic hilar lymphadenectomy of radical gastrectomy for the advanced proximal gastric cancer, some scholars hold dissenting opinion about surgical safety, surgical approach, total gastrectomy splenectomy, the routine splenic vessel posterior lymph nodes dissection, etc. In this paper, we will review the current status of splenic hilar lymph node for radical gastrectomy for the advanced proximal gastric cancer, and the controversy of splenic hilar lymphadenectomy, different laparoscopic surgical approach and so on. Key words: Stomach neoplasms; Lymph nodes; Gastrectomy; Lymph node excision