OBJECTIVES: The purpose of this study was to evaluate the risk factors that influence the difficulty of performing laparoscopic spleen-preserving splenic hilar lymph node dissection (SHLND) for @entity356 and to establish a simple and effective scoring system to predict the surgical difficulty preoperatively. METHODS: Between January 2011 and December 2013, we prospectively collected and retrospectively analyzed the medical records of 317 @entity1 with upper- or middle-third @entity356 who underwent laparoscopic spleen-preserving SHLND. Univariate and multivariate analyses were performed to determine the independent predictors for surgical difficulty based on the operation time during spleen-preserving SHLND. A logistic regression model was used to identify determinant variables and construct a predictive difficulty scoring system. RESULTS: Multivariate analysis showed that gender, body mass index (BMI), number of @entity432 ( @entity432 ), and type of @entity23114 were independently predictive factors of operation time. According to these factors, we developed a predictive surgical difficulty scoring system and the difficulty levels are divided into 0, 1, 2, 3, and 4 points or more. Based on the relative risk, we stratified the surgical difficulty into the following three divisions: 0 low difficulty, 1-2 intermediate difficulty, and 3 points or more high difficulty. The @entity1 with long operation time accounted for 19.6, 43.6, and 90.9  % for the three groups, respectively (p  <  0.001). The area under the receiver operating characteristic curve for the logistic regression model and the simplified difficulty scoring prediction model was 0.717 and 0.715, respectively. CONCLUSIONS: Based on four independent risk factors, including gender, BMI, number of @entity432 , and type of @entity23114 , we developed a simple and effective scoring system to predict the difficulty of laparoscopic spleen-preserving SHLND preoperatively. This novel scoring system might aid surgeons with different experience in performing operations at different levels of difficulty.

A preoperatively predictive difficulty scoring system for laparoscopic spleen-preserving splenic hilar lymph node dissection for XXXX : experience from a large-scale single center.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity432 :: ('MESH:D001157', 'Disease') :: ['splenic lobar arteries', 'SLAs'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer'] @entity23114 :: ('6503', 'Gene') :: ['SLA']
@entity356 :: (MESH:D013274,Disease) :: ['gastric cancer']
