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Efficacy of the fat-dissociation method for nodal harvesting in gastric cancer

World Journal of Gastrointestinal Surgery 2020年第6期12卷 277-286页

作者： Shinichi Kinami Toshio Ohnishi Naohiko Nakamura Zhi Yong Jiang Takashi Miyata Hideto Fujita Hiroyuki Takamura Nobuhiko Ueda Takeo Kosaka Department of Surgical Oncology Kanazawa Medical UniversityKahoku-gunIshikawa920-0293Japan

BACKGROUND There is an increased need for accurate staging for gastric cancer treatment.Consequently, it is necessary to carefully examine all dissected lymph nodes for precise staging. Recently, the fat-dissociation method has been developed as a quick and accurate method for harvesting dissected lymph nodes of colorectal cancer cases.AIM To investigate the usefulness of the fat-dissociation method for harvesting dissected lymph nodes of gastric cancer cases.METHODS Fifty-six resected specimens from gastric cancer patients who underwent standard curative gastrectomy and lymph node dissection at our hospital were used. Group 2 lymph nodes were separated from each specimen, and the remaining adipose tissue containing the group 1 lymph nodes was used. Some resected specimens were subjected to the fat-dissociation method. One vial of Imofully~? was dissolved in 50 m L of saline and injected into the tissue. The tissue was incubated for 1 h and the dissolved fat was removed. Subsequently, the nodes were identified, picked up with scissors, and mapped. The number of nodes in each lymphatic compartment and duration of lymph node harvest and mapping were compared.RESULTS The fat-dissociation method was used for 24 samples, while the conventional dissection method was used for 32 samples. The total number of harvested lymph nodes was 45.9 in the fat dissociation group and 44.3 in the control group, and there was no significant difference between the two groups. There were also no significant differences in the number of lymph nodes between the two groups based on a comparison of the lymphatic compartments. However, the total median duration of the fat-dissociation method was 38.2 min, reflecting a reduced duration of approximately 60 min compared to the control group.CONCLUSION Based on our results, the fat-dissociation method is effective in shortening the duration of lymph node harvest in gastric cancer surgery.

关键词： Gastric cancer Lymph node dissection Staging Lymph node mapping fatdissociationmethod Efficacy

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