J Gastric Cancer.  2020 Mar;20(1):19-28. 10.5230/jgc.2020.20.e10.

Advantages of Splenic Hilar Lymph Node Dissection in Proximal Gastric Cancer Surgery

Affiliations
  • 1Department of General Surgery, Karadeniz Technical University College of Medicine, Trabzon, Turkey.
  • 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. wjhyung@yuhs.ac

Abstract

Gastrectomy with lymph node dissection remains the gold standard for curative treatment of gastric cancer. Dissection of splenic hilar lymph nodes has been included as a part of D2 lymph node dissection for proximal gastric cancer. Previously, pancreatico-splenectomy has been performed for dissecting splenic hilar lymph nodes, followed by pancreas-preserving splenectomy and spleen-preserving lymphadenectomy. However, the necessity of routine splenectomy or splenic hilar lymph node dissection has been under debate due to the increased morbidity caused by splenectomy and the poor prognostic feature of splenic hilar lymph node metastasis. In contrast, the relatively high incidence of splenic hilar lymph node metastasis, survival advantage, and therapeutic value of splenic hilar lymph node dissection in some patient subgroups, as well as the effective use of novel technologies, still supports the necessity and applicability of splenic hilar lymph node dissection. In this review, we aimed to evaluate the need for splenic hilar lymph node dissection and suggest the subgroup of patients with favorable outcomes.

Keyword

Stomach neoplasms; Splenectomy; Spleen preservation; Lymph node dissection; Prognosis

MeSH Terms

Gastrectomy
Humans
Incidence
Lymph Node Excision*
Lymph Nodes*
Neoplasm Metastasis
Prognosis
Splenectomy
Stomach Neoplasms*
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