Laparoscopic Spleen-Preserving No. 10 Lymph Node Dissection for AGC

Inclusion Criteria: * Patients age older than 18 years (including 18 years old); * The primary lesion is located in the upper or middle third of the stomach, including Siewert II type and Siewert III type adenocarcinoma of the esophagogastric junction; * Pathologically confirmed primary gastric adenocarcinoma by endoscopic biopsy (including papillary, tubular, mucinous, signet ring cell and poorly differentiated adenocarcinoma); * Preoperative cancer stage cT2-4aN0-3M0 (according to AJCC-7th TNM staging); * The Eastern Cooperative Oncology Group performance status of 0 or 1; * The American Society of Anesthesiology classes of I, II or III; * Signed Informed consent. Exclusion Criteria: * Pregnant or lactating women; * Suffering from severe mental disorder; * Previous gastrectomy, including endoscopic submucosal dissection and endoscopic mucosal resection; * Integrated or enlarged lymph node with maximum diameter larger than 3 cm according to preoperative imaging, including significantly enlarged or bulky No. 10 lymph nodes; * Siewert I type adenocarcinoma of the esophagogastric junction; * Other malignant diseases (within 5 years); * Other illnesses needed operation concurrently; * Complications (bleeding, perforation or obstruction) required emergency surgery due to primary gastric malignancy; * Pulmonary function tests FEV1 less than 50% of predicted value; * Patient suffered from bleeding tendency disease such as hemophilia or took anti-coagulant medication due to deep …