Improved physical condition by limiting lymphadenectomy around the coeliac artery after distal gastrectomy for gastric cancer.

OBJECTIVE

To find out whether a less extensive lymphadenectomy could relieve the postoperative symptoms associated with D2 resection of gastric cancer.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Japan.

SUBJECTS

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.

INTERVENTIONS

Questionnaires sent out in February 1996.

MAIN OUTCOME MEASURES

Short term and long term morbidity.

RESULTS

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.

CONCLUSION

Limiting coeliac dissection during curative distal gastrectomy can improve the patients' physical condition postoperatively.