J Korean Surg Soc.  2013 May;84(5):304-308.

Laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for advanced gastric cancer with isolated para-aortic lymph node metastasis

  • 1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. hhkim@snubh.org
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.


Prophylactic para-aortic lymphadenectomy is not recommended in curable advanced gastric cancer. However, there are few reports on therapeutic para-aortic lymphadenectomy after palliative chemotherapy in far advanced gastric cancer. We report three cases of laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for the first time in Korea. Three gastric cancer patients with isolated para-aortic lymph node (PAN) metastasis showed partial response to capecitabine-based chemotherapy, and laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy was performed with curative intent. The mean total operation time was 365 minutes (range, 310 to 415 minutes), and the mean estimated blood loss was 158 mL (range, 125 to 200 mL). The mean number of retrieved PAN was 9 (range, 8 to 11), and all pathologic results showed no metastasis of para-aortic region. All patients recovered and were discharged without any significant complications.


Laparoscopy; Gastric cancer; Para-aortic lymphadenectomy

MeSH Terms

Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Stomach Neoplasms


  • Fig. 1 Ports placement for laparoscopy-assisted total gastrectomy with para-aortic lymphadenectomy.

  • Fig. 2 (A) Completed 16a2 lymph node dissection. (B) Completed 16b1 lymph node dissection. (C) Specimen of para-aortic lymphadenectomy. IVC, inferior vena cava.


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