Harvesting lymph nodes in gastric cancer surgery: A prospective randomized controlled study.

28 Background: Harvesting lymph node (LN) after gastrectomy is essential for accurate staging. Conventional method (CONV) to retrieve LN immediately after surgery is accepted in Japan but its efficacy and quality highly depends on the case and examiners. Another method is to retrieve LN stained by methylene blue dye (MBD), by which the physicians may easily pick up blue LN. This trial evaluated the efficiency and quality of both methods in randomized fashion. Methods: Key eligible criteria are as follows. (i) Histologically proven adenocarcinoma of the stomach, (ii) Clinical stage I-III, (iii) R0 resection is planned by gastrectomy with D1+ or D2 lymphadenectomy. Examiners for harvesting LN are qualified based on the experience. After curative surgery, LNs are harvested from the specimen immediately after surgery in the CONV group and from the specimens who had been fixed with 10% buffered formalin with methylene blue for 48 hours in the MBD group. The primary endpoint is the ratio of the pathological num...