Impact of Intraoperative Ultrasonography on Metastatic Lymph Node Detection in Laparoscopic Gastric Cancer Surgery
Makaleler > Tam Makale · 2026
Yazarlar: Selim Tamam, Serdar Çulcu, KAMİL ERÖZKAN, Mehmet Şah Benk, Cengiz Ceylan, Ezgi Cengiz, Ali Ekrem Ünal
Turkish Journal of Surgical Oncology, Uluslararası, 2026, cilt 2
DOI: 10.4274/turkjsurgoncol.galenos.2026.55264
Özet
Objectives: Laparoscopic D2 lymphadenectomy in gastric cancer surgery is technically demanding due to the close anatomical relationship with major vascular structures and the pancreatic parenchyma.This study investigated whether intraoperative ultrasonography (IOUS) influences early surgical and short-term oncologic outcomes in patients undergoing laparoscopic total gastrectomy. Material and Methods:In this single-center retrospective comparative cohort study, between November 2023 and November 2025, a total of 78 patients underwent laparoscopic D2 lymph node dissection with IOUS guidance, of whom 31 underwent total gastrectomy.These patients were compared with 28 patients who underwent laparoscopic total gastrectomy and D2 lymph node dissection without IOUS between November 2021 and November 2023.The two groups were evaluated with respect to demographic characteristics, early perioperative outcomes, postoperative complications, and the total number of lymph nodes dissected and the number of metastatic lymph nodes.Results: A total of 59 patients with gastric cancer were included in the analysis: 28 in the non-IOUS group and 31 in the IOUS group.No significant differences were observed between the groups with respect to demographic characteristics, clinical variables, or preoperative laboratory parameters (all p>0.05).Intraoperative complication rates (14.3% vs. 9.7%), postoperative complication profiles, requirements for erythrocyte suspension transfusion, operative time (median 200 minutes), intensive care unit stay, and total length of hospital stay were comparable between groups (p>0.05).There was no significant difference in the total number of dissected lymph nodes (p=0.773).The number of metastatic lymph nodes was low in both groups, and there was no significant difference associated with the use of IOUS (p=0.605).Conclusion: IOUS may be considered a supportive technique that contributes to anatomical delineation and surgical safety during laparoscopic gastric cancer surgery.Further studies with larger patient cohorts are warranted to clarify its potential impact on oncological outcomes.