Ichikura T, Tomimatsu S, Okusa Y, Mochizuki H
First Department of Surgery, National Defense Medical College Hospital, Tokorozawa, Japan.
Eur J Surg. 1999 Feb;165(2):123-32. doi: 10.1080/110241599750007306.
To find out whether a less extensive lymphadenectomy could relieve the postoperative symptoms associated with D2 resection of gastric cancer.
Retrospective study.
Teaching hospital, Japan.
142 patients who had dissection along the left gastric and common hepatic arteries and dissection of the perigastric nodes during curative distal gastrectomy without splenectomy or pancreatectomy between 1990 and 1994. 79 who had no dissection around the coeliac artery were compared with 63 who had.
Questionnaires sent out in February 1996.
Short term and long term morbidity.
The patients who had had coeliac dissection were significantly more likely to prefer digestible and light food (p = 0.006); and were significantly more likely to complain of diarrhoea (p = 0.001), abdominal pain (p = 0.02), and late dumping (p = 0.03) than those who did not. Patients who had had coeliac dissection tended to eat more digestible foods in smaller volumes/meal during the early postoperative years, and had more abdominal pain, fullness, and oesophageal reflux during the later years.
Limiting coeliac dissection during curative distal gastrectomy can improve the patients' physical condition postoperatively.
探究范围较小的淋巴结清扫术是否能缓解与胃癌D2切除术相关的术后症状。
回顾性研究。
日本教学医院。
1990年至1994年间接受根治性远端胃切除术且未行脾切除术或胰腺切除术的142例患者，术中沿胃左动脉和肝总动脉进行了淋巴结清扫及胃周淋巴结清扫。将79例未行腹腔动脉周围淋巴结清扫的患者与63例行该清扫的患者进行比较。
1996年2月发放问卷。
短期和长期发病率。
行腹腔动脉周围淋巴结清扫的患者明显更倾向于选择易消化的清淡食物（p = 0.006）；与未行清扫的患者相比，他们更易出现腹泻（p = 0.001）、腹痛（p = 0.02）及晚期倾倒综合征（p = 0.03）。行腹腔动脉周围淋巴结清扫的患者在术后早期倾向于食用量少且易消化的食物，而在后期则有更多的腹痛、饱腹感及食管反流症状。
在根治性远端胃切除术中限制腹腔动脉周围淋巴结清扫可改善患者术后身体状况。
