Luna Alexis, Rebasa Pere, Montmany Sandra, Navarro Salvador
Department of General Surgery, Hospital Universitari Parc Taulí, Sabadell, Catalonia, Spain.
ISRN Surg. 2013 Jun 16;2013:508719. doi: 10.1155/2013/508719. Print 2013.
Background. D2 lymphadenectomy is a demanding technique which is associated with high morbidity in the West. We report our experience with D2 lymphadenectomy after a training period in Japan. Methods. Prospective, descriptive study in 133 consecutive patients undergoing radical gastrectomy for gastric adenocarcinoma from 2005 to 2011. We analysed the number of lymph nodes removed, observed morbidity/mortality compared with the predictions of POSSUM and O-POSSUM, survival, and disease-free interval for patients with D1 and D2 lymphadenectomy. Results. The morbidity rate in patients with D1 lymphadenectomy was 59.4%. For D2 it was 47.7%. The mortality rate in patients with D1 was 6.7%. In the D2 group it was 6.8%. Median survival was 42.9 months in D1 and 55 months in D2. The disease-free interval was 49 months for D1 and 58 months for D2. Conclusion. The learning curve for D2 lymphadenectomy presents acceptable rates of morbidity and mortality, providing that the technique is learnt at a center with extensive experience.
背景。D2淋巴结清扫术是一项要求较高的技术，在西方与高发病率相关。我们报告了在日本经过一段培训期后进行D2淋巴结清扫术的经验。方法。对2005年至2011年连续133例行胃癌根治性切除术的患者进行前瞻性描述性研究。我们分析了清扫的淋巴结数量、观察到的发病率/死亡率（与POSSUM和O-POSSUM预测值相比）、生存率以及接受D1和D2淋巴结清扫术患者的无病生存期。结果。D1淋巴结清扫术患者的发病率为59.4%。D2淋巴结清扫术患者的发病率为47.7%。D1淋巴结清扫术患者的死亡率为6.7%。D2组的死亡率为6.8%。D1组的中位生存期为42.9个月，D2组为55个月。D1组的无病生存期为49个月，D2组为58个月。结论。只要在经验丰富的中心学习该技术，D2淋巴结清扫术的学习曲线呈现出可接受的发病率和死亡率。
