Research Article
Volume 8 Issue 3 - 2021
Standardizing D2 Lymphadenectomy in Gastric Cancer Using Checklist: A Retrospective Analysis of Prospective Cohort
Anuj Parajuli*, Roshan Ghimire, Dhiresh Kumar Maharjan, Prabin Bikram Thapa and Suman Shrestha
Department of Surgery, Kathmandu Medical College and Teaching Hospital, Nepal
*Corresponding Author: Anuj Parajuli, Department of Surgery, Kathmandu Medical College and Teaching Hospital, Nepal.
Received: February 15, 2021; Published: February 26, 2021




Abstract

Background: R0 surgical resection with D2 lymphadenectomy has been the cornerstone treatment in major gastric cancer guidelines for resectable locally advanced gastric cancer. The extent of D2 lymphadenectomy may vary among surgeons because of technical difficulty and lack of anatomical definition of individual lymph node (LN) stations.

Objective: To standardize our surgical quality of D2 lymphadenectomy and improve surgical proficiency using checklist method.

Method: In this retrospective analysis of a prospective cohort, all consecutive resectable gastric cancer patients who underwent curative gastrectomy with D2 lymphadenectomy in Kathmandu medical college and teaching hospital (KMCTH) were analyzed. A complete unedited video of our surgical procedure was recorded and evaluation was done for completeness of D2 lymphadenectomy. Surgical compliance (removal of indicated lymph node stations) and surgicopathological compliance (removal of > 15 lymph nodes) were recorded and assessed.

Results: Out of 56 resectable gastrectomy patients, 41 (73.2%) were male and the mean age was 62 years. Average duration of surgery was 222 mins and mean hospital stay was 7 days. Surgical compliance occurred in 51 (91.1%) with 100% surgicopathological compliance. Median lymph node (LN) retrieved was 24.

Conclusion: Surgical quality can be standardized using checklist in D2 lymphadenectomy for gastric cancers.

Keywords: Gastric Cancer; D2 Lymphadenectomy; Standardization

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Citation: Anuj Parajuli., et al. ““Standardizing D2 Lymphadenectomy in Gastric Cancer Using Checklist: A Retrospective Analysis of Prospective Cohort”. EC Gastroenterology and Digestive System 8.3 (2021): 132-138.

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