Spleen pull-out lymph node dissection safe for gastric cancer

The use of spleen pull-out lymph node dissection in the splenic hilum is both safe and feasible for patients with gastric cancer undergoing radical gastrectomy, a recent study has found.

Drawing from the online databases of PubMed, Embase, Cochrane, CNKI, China Biomedical Literature, and Wanfang, the researchers included nine studies in the meta-analysis, all of which had been performed in China. Only those that compared in vitro pull-out with in situ splenic hilar lymph node dissection were eligible, those that performed assessments on patients with other tumours were excluded.

Patients in the in situ hilar lymph node dissection group saw a significantly shorter operation time (standardized mean difference [SMD], 0.26, 95 percent confidence interval [CI], 0.09–0.43; p=0.002) and lost significantly less blood intraoperatively (SMD, 0.70, 95 percent CI, 0.56–0.85; p=0.000).

A significantly higher number of extracted lymph nodes was also observed in the spleen extraction group (SMD, –1.23, 95 percent CI, –1.53 to –0.94; p=0.000), along with a significantly higher positive rate of splenic hilum lymph nodes (odds ratio [OR], 0.68, 95 percent CI, 0.53–0.88; p=0.003).

In contrast, complications occurred at a comparable rate between the two groups (OR, 1.11, 95 percent CI, 0.63–1.94; p=0.719).

“We discovered that it is safe and feasible to use spleen pull-out lymph node dissection in the splenic hilum during radical gastrectomy for gastric cancer,” the researchers said. “It has high clinical application value and is worthy of clinical promotion.”