Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer

Kun Yang, Minah Cho, Chul Kyu Roh, Won Jun Seo, Seohee Choi, Taeil Son, Hyoung Il Kim, Woo Jin Hyung

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Robotic system may have potential advantages to facilitate the technically challenging splenic hilar lymphadenectomy during gastrectomy for gastric cancer. However, robotic spleen-preserving splenic hilar lymphadenectomy is performed infrequently not only because of the limited availability of the robot but also because of its technical difficulty. In this study, we describe our technique of performing robotic spleen-preserving splenic hilar lymphadenectomy in detail to facilitate wider application and present operative outcomes and the follow-up results of the procedure. Methods: From 2005 to 2015, 93 patients underwent robotic total gastrectomy with D2 lymphadenectomy. One patient with obvious lymph node (LN) metastasis received splenectomy and was excluded from the analysis. Intraoperative complications, operation and console time, estimated blood loss, postoperative morbidity and mortality, the number of harvested LNs in total and at the splenic hilum, and 5-year overall survival were analyzed, retrospectively. Results: Among the 92 patients, robotic spleen-preserving splenic hilar lymphadenectomy was successfully performed in 91 patients except one who experienced intraoperative splenic artery injury which demanded splenectomy to be performed simultaneously. The overall mean operation time and console time were 287.2 ± 66.0 and 180.2 ± 47.2 min, respectively. Mean estimated blood loss was 141.1 ± 227.0 ml. The mortality was 1.1% (1/92). The overall postoperative morbidity rate was 16.3% (15/92). There was no case of pancreatic fistula, whole splenic infarction, or the delayed aneurysm of splenic artery. The mean numbers of harvested LNs in total and at the splenic hilum were 50.8 ± 18.1 and 1.9 ± 2.6. The 5-year overall survival was 86.3% and 5-year recurrence-free survival was 87.4%. Conclusion: This study suggests that robotic application for spleen-preserving splenic hilar lymphadenectomy could be a feasible and safe method.

Original languageEnglish
JournalSurgical endoscopy
DOIs
Publication statusPublished - 2019 Jan 1

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Robotics
Gastrectomy
Lymph Node Excision
Stomach Neoplasms
Spleen
Splenic Artery
Splenectomy
Survival
Splenic Infarction
Morbidity
Pancreatic Fistula
Postoperative Hemorrhage
Mortality
Intraoperative Complications
Aneurysm
Lymph Nodes
Neoplasm Metastasis
Recurrence
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Yang, Kun ; Cho, Minah ; Roh, Chul Kyu ; Seo, Won Jun ; Choi, Seohee ; Son, Taeil ; Kim, Hyoung Il ; Hyung, Woo Jin. / Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. In: Surgical endoscopy. 2019.
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abstract = "Background: Robotic system may have potential advantages to facilitate the technically challenging splenic hilar lymphadenectomy during gastrectomy for gastric cancer. However, robotic spleen-preserving splenic hilar lymphadenectomy is performed infrequently not only because of the limited availability of the robot but also because of its technical difficulty. In this study, we describe our technique of performing robotic spleen-preserving splenic hilar lymphadenectomy in detail to facilitate wider application and present operative outcomes and the follow-up results of the procedure. Methods: From 2005 to 2015, 93 patients underwent robotic total gastrectomy with D2 lymphadenectomy. One patient with obvious lymph node (LN) metastasis received splenectomy and was excluded from the analysis. Intraoperative complications, operation and console time, estimated blood loss, postoperative morbidity and mortality, the number of harvested LNs in total and at the splenic hilum, and 5-year overall survival were analyzed, retrospectively. Results: Among the 92 patients, robotic spleen-preserving splenic hilar lymphadenectomy was successfully performed in 91 patients except one who experienced intraoperative splenic artery injury which demanded splenectomy to be performed simultaneously. The overall mean operation time and console time were 287.2 ± 66.0 and 180.2 ± 47.2 min, respectively. Mean estimated blood loss was 141.1 ± 227.0 ml. The mortality was 1.1{\%} (1/92). The overall postoperative morbidity rate was 16.3{\%} (15/92). There was no case of pancreatic fistula, whole splenic infarction, or the delayed aneurysm of splenic artery. The mean numbers of harvested LNs in total and at the splenic hilum were 50.8 ± 18.1 and 1.9 ± 2.6. The 5-year overall survival was 86.3{\%} and 5-year recurrence-free survival was 87.4{\%}. Conclusion: This study suggests that robotic application for spleen-preserving splenic hilar lymphadenectomy could be a feasible and safe method.",
author = "Kun Yang and Minah Cho and Roh, {Chul Kyu} and Seo, {Won Jun} and Seohee Choi and Taeil Son and Kim, {Hyoung Il} and Hyung, {Woo Jin}",
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Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. / Yang, Kun; Cho, Minah; Roh, Chul Kyu; Seo, Won Jun; Choi, Seohee; Son, Taeil; Kim, Hyoung Il; Hyung, Woo Jin.

In: Surgical endoscopy, 01.01.2019.

Research output: Contribution to journalArticle

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T1 - Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer

AU - Yang, Kun

AU - Cho, Minah

AU - Roh, Chul Kyu

AU - Seo, Won Jun

AU - Choi, Seohee

AU - Son, Taeil

AU - Kim, Hyoung Il

AU - Hyung, Woo Jin

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Y1 - 2019/1/1

N2 - Background: Robotic system may have potential advantages to facilitate the technically challenging splenic hilar lymphadenectomy during gastrectomy for gastric cancer. However, robotic spleen-preserving splenic hilar lymphadenectomy is performed infrequently not only because of the limited availability of the robot but also because of its technical difficulty. In this study, we describe our technique of performing robotic spleen-preserving splenic hilar lymphadenectomy in detail to facilitate wider application and present operative outcomes and the follow-up results of the procedure. Methods: From 2005 to 2015, 93 patients underwent robotic total gastrectomy with D2 lymphadenectomy. One patient with obvious lymph node (LN) metastasis received splenectomy and was excluded from the analysis. Intraoperative complications, operation and console time, estimated blood loss, postoperative morbidity and mortality, the number of harvested LNs in total and at the splenic hilum, and 5-year overall survival were analyzed, retrospectively. Results: Among the 92 patients, robotic spleen-preserving splenic hilar lymphadenectomy was successfully performed in 91 patients except one who experienced intraoperative splenic artery injury which demanded splenectomy to be performed simultaneously. The overall mean operation time and console time were 287.2 ± 66.0 and 180.2 ± 47.2 min, respectively. Mean estimated blood loss was 141.1 ± 227.0 ml. The mortality was 1.1% (1/92). The overall postoperative morbidity rate was 16.3% (15/92). There was no case of pancreatic fistula, whole splenic infarction, or the delayed aneurysm of splenic artery. The mean numbers of harvested LNs in total and at the splenic hilum were 50.8 ± 18.1 and 1.9 ± 2.6. The 5-year overall survival was 86.3% and 5-year recurrence-free survival was 87.4%. Conclusion: This study suggests that robotic application for spleen-preserving splenic hilar lymphadenectomy could be a feasible and safe method.

AB - Background: Robotic system may have potential advantages to facilitate the technically challenging splenic hilar lymphadenectomy during gastrectomy for gastric cancer. However, robotic spleen-preserving splenic hilar lymphadenectomy is performed infrequently not only because of the limited availability of the robot but also because of its technical difficulty. In this study, we describe our technique of performing robotic spleen-preserving splenic hilar lymphadenectomy in detail to facilitate wider application and present operative outcomes and the follow-up results of the procedure. Methods: From 2005 to 2015, 93 patients underwent robotic total gastrectomy with D2 lymphadenectomy. One patient with obvious lymph node (LN) metastasis received splenectomy and was excluded from the analysis. Intraoperative complications, operation and console time, estimated blood loss, postoperative morbidity and mortality, the number of harvested LNs in total and at the splenic hilum, and 5-year overall survival were analyzed, retrospectively. Results: Among the 92 patients, robotic spleen-preserving splenic hilar lymphadenectomy was successfully performed in 91 patients except one who experienced intraoperative splenic artery injury which demanded splenectomy to be performed simultaneously. The overall mean operation time and console time were 287.2 ± 66.0 and 180.2 ± 47.2 min, respectively. Mean estimated blood loss was 141.1 ± 227.0 ml. The mortality was 1.1% (1/92). The overall postoperative morbidity rate was 16.3% (15/92). There was no case of pancreatic fistula, whole splenic infarction, or the delayed aneurysm of splenic artery. The mean numbers of harvested LNs in total and at the splenic hilum were 50.8 ± 18.1 and 1.9 ± 2.6. The 5-year overall survival was 86.3% and 5-year recurrence-free survival was 87.4%. Conclusion: This study suggests that robotic application for spleen-preserving splenic hilar lymphadenectomy could be a feasible and safe method.

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