PP 75. Upper Lesser Curvature Skeletonization in Radical Distal Gastrectomy

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X. Chen, W. Zhang, H. Jian-Kun

16:36 - 16:42h at Margrit Room

Categories: Gastrointestinal Surgery, Poster Session

Session: Poster II (P1) - Gastrointestinal Surgery

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Background
The lesser curvature skeletonization in radical distal gastrectomy is of importance to evaluate lymph node stations and is often neglected, especially in the Western. This study was to figure out metastatic status and its risk factors of lesser curvature regional node (LCRN), i.e. no. 1, 3a and 3b groups, in radical distal gastrectomy with upper lesser curvature skeletonization.

Material and Methods
Patients undergone radical distal gastrectomies were retrospectively collected during 2010.5- 2013.9. The clinicopathological features and surgical outcomes were compared between LCRN (+) and (-) groups. The correlations among no. 1, 3a, 3b and other groups were analyzed. Univariate and multivariate analyses were performed to identify the independent risk factor for LCRN metastasis.

Result
Totally, 112 patients were analyzed and 45.5% had metastatic LCRNs, while the overall node positive cases were 59.8%. LCRN (+) and (-) groups had significantly different features, concerning gender, tumor size, histological grade, Lauren classification, gross type, T, N and TNM stages. Positivity of no. 1, 3a and 3b groups were 4.5%, 38.4% and 32.1%, respectively. Elsewise, no. 1, 3a and 3b groups were comprehensively correlated with D2 tier groups. Through univariate and multivariate analyses, only stage T3-4 and positive no. 4d nodes were documented as independent risk factors, while no. 5 and 11p nodes showed a trend.

Conclusion
Upper lesser curvature skeletonization can be recommended as a standard procedure in radical distal gastrectomy for the sake of thorough clearance at gastric stump, especially for T3-4 or no. 4d group suspicious cases.