Published online Sep 15, 2000. doi: 10.3748/wjg.v6.iSuppl3.131
Revised: June 5, 2000
Accepted: July 10, 2000
Published online: September 15, 2000
AIM: To study the safety and the traumatic degree of D4 approach by retrospective analysis of the para-operative data from the para-aortic lymph nodes excision in comparison with those from standard radical resection in advanced gastric cancer (AGC).
METHODS: Several para-operative data including the resectability, the mortality, the complicated morbidity, the amount of transfused blood, and the hospitalized days relating to the operation were analyzed statistically between D4 (n = 30) and D2 lymph nodes excision (n = 34) groups. The data expressed as means ± SD was analyzed statistically by Student’s t test. Percentage of the data was analyzed by χ2 test statistically. It was taken as significant difference if P value was less than 0.05.
RESULTS: The percentage of palliated resection in D4 group was significantly lower than that in D2 group (16.67% vs 47.06%, P < 0.05). This D4 radical resection would indeed prolong the drainage time (7.35 ± 0.98 d vs 14.78 ± 2.16 d, P < 0.01). The amount of transfused blood during operation (774.32 ± 112.09 mL) and the operative consuming time in D4 group (7.14 ± 0.39 h) increased significantly too compared with those in D2 group (538.67 ± 59.87 mL, P < 0.05; 4.12 ± 0.18 h, P < 0.05), suggesting that the dramatic degree of D4 operation was severer than that of D2 operation. But the mortality, the morbidity of complication and the hospitalized time after D4 operation did not increase significantly, indicating that D4 lymph nodes excision as a choice of the surgical treatment of AGC was safe and feasible.
CONCLUSION: D4 lymph nodes excision for AGC is safe, reasonable and feasible.