Laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for advanced gastric cancer with isolated para-aortic lymph node metastasis
A 63 year-old man was diagnosed with a poorly cohesive adenocarcinoma in the gastric lower body, and a PET-CT suggested multiple perigastric and left PAN metastases. After completing 7 cycles of XP and 5 cycles of Xeloda, he showed a partial response to the chemotherapy with decreased sizes of perigastric and left PANs. He underwent laparoscopic subtotal gastrectomy with para-aortic lymphadenectomy successfully. The total operative time was 310 minutes and para-aortic lymphadenectomy was performed during 93 minutes. The EBL was 150 mL. The pathologic results revealed subserosa tumor and 3 LNs metastases in harvested 35 LNs (16a2 [0/0], 16b1 [0/8]). He was discharged at 8 days postoperatively without any complications.