Standardization of lymph node dissection in hand-assisted laparoscopic radical gastrectomy for stomach cancer

Objective: To assess the standardization of lymphadenectomy in hand-assisted laparoscopic radical gastrectomy for stomach cancer using nanocarbon particles as lymph node(LN) tracer. Methods: The clinical data of 40 patients with gastric cancer undergoing hand-assisted laparoscopic surgery for radical gastrectomy within a period of 8 months were retrospectively analyzed.Of the patients,15 cases who received intraoperative nanocarbon suspension injection before LN clearance were designated as observation group,and another 25 cases served as control group. Results: Of the 15 patients in observation group,the LNs along the lesser curvature of the stomach were labeled in 12 cases(80.00%),No.8a or No.6 LNs staining were found in 8 cases each(53.33%),and the LNs staining were found in 3 cases each(20.00%) in the splenic hilum or greater curvature of the stomach.All the main surgical indexes that included the incision length [(6.90±0.28) cm vs.(6.82±0.38) cm],intraoperative blood loss [(286±168) mL vs.(235±98) mL],operative time [(182±31) min vs.(176±21) min],number of lymph nodes detected(16.8±6.71 vs.14.9±3.90),and length of postoperative hospital stay [(10.1±3.8) d vs.(11.6±6.5) d],between the observation group and control group showed no statistical differences(all P0.05). Conclusion: The application of LN tracer has certain adjunctive effects for improving the LN dissection during surgery.The use of tracer in hand-assisted laparoscopic radical gastrectomy can better reflect the standardization of LN dissection.