Objective:By employing video laparoscopy, we further demonstrated that mesogastrium, covered by Proper Fascia with anterior surface (A) and posterior surface (P) extends towards and fuses with the “mesogastrium bed”. Therefore, D2 lymphadenectomy plus complete mesogastrium excision (CME) is proposed as a novel approach to en bloc for advanced gastric cancer.Methods: This study was approved by the Tongji Hospital Ethics Committee.Results:A total of 54 patients underwent laparoscopic D2+CME with membrane anatomy. hTe mean number of retrieved regional lymph nodes was 35.04±10.70 (range, 14-55 lymph nodes). The mean volume of blood loss was 12.44±22.89 mL. No operative complication was observed during hospitalization.Conclusion:We believe that the laparoscopic D2 plus CME can minimize the differences in the number of lymph nodes harvested, and substantially reduce the intraoperative blood losses and surgery-related injuries in advanced gastric cancer patients.
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