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Abstract：
UNASSIGNED: For patients who need laparoscopic radical gastrectomy, lymph node dissection (LND) and optimization of surgical procedures are particularly important. This study introduces the \"quadrant-sandwich\" method in clockwise modular D2 LND and evaluates the advantages and safety of this method.
UNASSIGNED: The clinical data of 108 laparoscopic total gastrectomy patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from January 2019 to January 2022 were retrospectively analyzed. Based on the different LND processes, 55 patients were allocated to the observation group, which underwent clockwise modular LND using the \"quadrant-sandwich method\", and 53 patients were allocated to the control group, which underwent traditional LND. The effectiveness and safety of the approach in terms of operation time, blood loss, lymph node yield, postoperative recovery and postoperative complications were observed in the two groups.
UNASSIGNED: There was no statistical difference between the baseline data of the two groups. In relation to the surgery, the observation group had an operation time of 227.0±48.5 minutes, and intraoperative bleeding of 100.0 mL [inter-quartile range (IQR), 30.0-200.0 mL], while the control group had an operation time of 247±41.5 minutes, and intraoperative bleeding of 180.0 mL (IQR, 130.0-245.0 mL). There were statistically significant differences between the two groups in terms of the operation time and intraoperative bleeding (P=0.001, P=0.020). In relation to the LND, there were no statistically significant differences between the two groups in terms of the total number of lymph nodes in each division, and the number of positive lymph nodes. In relation to the post-operative results, there were no statistically significant differences between the two groups in terms of the post-operative pathological stage, first postoperative oral feeding, post-operative hospitalization time, and post-operative complications.
UNASSIGNED: Clockwise modular D2 LND using the \"quadrant-sandwich method\" is potentially safe and feasible in laparoscopic total gastrectomy. It not only ensures the thoroughness of the LND, but also ensures and efficient and fast surgical process, shortens the operation time, and reduces the amount of intraoperative bleeding.
UNASSIGNED: The clinical data of 108 laparoscopic total gastrectomy patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from January 2019 to January 2022 were retrospectively analyzed. Based on the different LND processes, 55 patients were allocated to the observation group, which underwent clockwise modular LND using the \"quadrant-sandwich method\", and 53 patients were allocated to the control group, which underwent traditional LND. The effectiveness and safety of the approach in terms of operation time, blood loss, lymph node yield, postoperative recovery and postoperative complications were observed in the two groups.
UNASSIGNED: There was no statistical difference between the baseline data of the two groups. In relation to the surgery, the observation group had an operation time of 227.0±48.5 minutes, and intraoperative bleeding of 100.0 mL [inter-quartile range (IQR), 30.0-200.0 mL], while the control group had an operation time of 247±41.5 minutes, and intraoperative bleeding of 180.0 mL (IQR, 130.0-245.0 mL). There were statistically significant differences between the two groups in terms of the operation time and intraoperative bleeding (P=0.001, P=0.020). In relation to the LND, there were no statistically significant differences between the two groups in terms of the total number of lymph nodes in each division, and the number of positive lymph nodes. In relation to the post-operative results, there were no statistically significant differences between the two groups in terms of the post-operative pathological stage, first postoperative oral feeding, post-operative hospitalization time, and post-operative complications.
UNASSIGNED: Clockwise modular D2 LND using the \"quadrant-sandwich method\" is potentially safe and feasible in laparoscopic total gastrectomy. It not only ensures the thoroughness of the LND, but also ensures and efficient and fast surgical process, shortens the operation time, and reduces the amount of intraoperative bleeding.
摘要：
■对于需要腹腔镜胃癌根治术的患者，淋巴结清扫术（LND）和外科手术的优化尤为重要。本研究介绍了顺时针模块化D2LND中的“象限三明治”方法，并评估了该方法的优点和安全性。
■回顾性分析2019年1月至2022年1月郑州大学附属肿瘤医院收治的108例腹腔镜全胃切除术患者的临床资料。基于不同的LND流程，55例患者被分配到观察组,使用“象限三明治法”进行顺时针模块化LND，53例患者被分配到对照组，经历了传统的LND。该方法在操作时间方面的有效性和安全性，失血,淋巴结产量，观察两组患者术后恢复情况及术后并发症发生情况。
■两组的基线数据之间没有统计学差异。关于手术，观察组手术时间为227.0±48.5分钟,术中出血100.0mL[四分位数间距（IQR），30.0-200.0mL],对照组手术时间为247±41.5分钟，术中出血180.0mL（IQR，130.0-245.0mL)。两组手术时间、术中出血量比较差异均有统计学意义(P=0.001,P=0.020)。关于LND，两组在每个分区的淋巴结总数方面没有统计学上的显著差异,和阳性淋巴结的数量。关于术后结果，两组术后病理分期差异无统计学意义,术后第一次口服喂养，术后住院时间,和术后并发症。
■使用“象限夹心法”顺时针模块化D2LND在腹腔镜全胃切除术中潜在安全可行。它不仅确保了LND的彻底性，而且还确保了高效和快速的手术过程，缩短手术时间，减少术中出血量。
■回顾性分析2019年1月至2022年1月郑州大学附属肿瘤医院收治的108例腹腔镜全胃切除术患者的临床资料。基于不同的LND流程，55例患者被分配到观察组,使用“象限三明治法”进行顺时针模块化LND，53例患者被分配到对照组，经历了传统的LND。该方法在操作时间方面的有效性和安全性，失血,淋巴结产量，观察两组患者术后恢复情况及术后并发症发生情况。
■两组的基线数据之间没有统计学差异。关于手术，观察组手术时间为227.0±48.5分钟,术中出血100.0mL[四分位数间距（IQR），30.0-200.0mL],对照组手术时间为247±41.5分钟，术中出血180.0mL（IQR，130.0-245.0mL)。两组手术时间、术中出血量比较差异均有统计学意义(P=0.001,P=0.020)。关于LND，两组在每个分区的淋巴结总数方面没有统计学上的显著差异,和阳性淋巴结的数量。关于术后结果，两组术后病理分期差异无统计学意义,术后第一次口服喂养，术后住院时间,和术后并发症。
■使用“象限夹心法”顺时针模块化D2LND在腹腔镜全胃切除术中潜在安全可行。它不仅确保了LND的彻底性，而且还确保了高效和快速的手术过程，缩短手术时间，减少术中出血量。
