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World J Gastroenterol. Apr 28, 2014; 20(16): 4797-4805
Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4797
Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4797
Role of 3DCT in laparoscopic total gastrectomy with spleen-preserving splenic lymph node dissection
Jia-Bin Wang, Chang-Ming Huang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jian-Xian Lin, Jun Lu, Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
Author contributions: Wang JB and Huang CM designed the research; Zheng CH, Li P and Xie JW performed the research; Lin JX and Lu J contributed to the diagnostic imaging work; Wang JB and Zheng CH analysed the data; Wang JB and Huang CM wrote the paper.
Correspondence to: Chang-Ming Huang, Professor, Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. hcmlr2002@163.com
Telephone: +86-591-83320319 Fax: +86-591-83320319
Received: January 8, 2014
Revised: February 24, 2014
Accepted: March 4, 2014
Published online: April 28, 2014
Processing time: 110 Days and 16.7 Hours
Revised: February 24, 2014
Accepted: March 4, 2014
Published online: April 28, 2014
Processing time: 110 Days and 16.7 Hours
Core Tip
Core tip: The JGCA guidelines recommend splenic hilar lymph node (LN) dissection in patients with upper- and middle-third advanced gastric cancer. However, the surgery is made more difficult by anatomic complications of the vessels around the stomach, particularly the splenic vessels, which are located in a narrow, deep space. The inability to intuitively judge the shape of the splenic vessels increases the likelihood of vascular injury. Preoperative assessment of the splenic vascular anatomy at the splenic hilum is important for the safe and rapid performance of laparoscopic spleen-preserving splenic hilar LN dissection. Computed tomography with 3D imaging can be used for surgical guidance to reduce the risks of splenic LN dissection.