The Significance Of The Dissection Of The Splenic Portal In Laparoscopic Radical Resection Of Gastric Carcinoma Under The Guidance Of Membrane Anatomy Theory

Object:To explore the feasibility,safety and clinical effect of splenic hilum dissection guided by membrane anatomy in laparoscopic radical gastrectomy.Methods:A retrospective analysis of 84 patients who underwent laparoscopic assisted radical gastrectomy from October 2015 to September 2016 in Henan Province People’s Hospital.There were 41 cases in the study group and 43 cases in the control group.There was no significant difference in general data between the two groups(P > 0.05),which was comparable.All patients were treated with laparoscopic radical gastrectomy in accordance with the scope of lymph node dissection of the fourth edition of the Japanese gastric cancer treatment guide 2014.The study group carried out splenic hilar lymph node dissection under the guidance of membrane anatomy theory,and the control group was guided by the routine blood vessel to scan the splenic hilar lymph node.By reviewing the surgical video and consulting the medical records,the two groups of patients were compared with the laparoscopic operation time,the amount of intraoperative bleeding,the number of total lymph nodes,the number of splenic lymph nodes,the injury of the spleen,the incidence of postoperative complications,the time of ventilation,the number of days in hospital,the rate of readmission,and so on.To explore the clinical significance of splenic hilum dissection guided by membrane anatomy in laparoscopic radical gastrectomy.Results:In the study group,the time of laparoscopic operation was less than that of the control group(54.88 ± 26.18 vs 101.28 ± 142.72,P < 0.05),and the amount of bleeding in the operation was less(54.88 ± 26.18 vs 101.28 ± 142.72,P < 0.05).The total lymph nodes in the study group were more than those in the control group(26.20 ± 8.40 vs 21.47 ± 6.84,P < 0.05),and the detected splenic hilar lymph nodes detected more(3.98 ± 1.59 vs 3.07 ± 1.37,P < 0.05).The spleen related complications of the study group were less than those of the control group(P < 0.05),but there was no significant difference in other complications during the perioperative period(P > 0.05).The average days of hospitalization were reduced(11.07 ± 3.23 vs 12.44 ± 2.97,P < 0.05).The average ventilation time of the digestive tract was reduced,but the difference was not statistically significant(3.07 ± 0.93 vs 3.40 ± 1.20,P > 0.05).There was no significant difference in postoperative readmission(P > 0.05).Conclusion:The splenic hilar lymph node dissection under the membrane anatomy theory has the advantages of short operation time,less intraoperative bleeding,thorough lymph node dissection,less splenic injury and no postoperative complications and reentry rate.The method is safe and reliable and is worthy of promotion and application in clinic.