Heesakkers J P, Gouma D J, Thunnissen F B, Bemelmans M H, Von Meyenfeldt M F
Department of Surgery, University Hospital Maastricht, Amsterdam, The Netherlands.
Br J Surg. 1994 Apr;81(4):551-3. doi: 10.1002/bjs.1800810422.
To assess the potential benefit of R2 gastrectomy for patients with early gastric cancer, complications and long-term survival of patients who underwent conventional resection with limited lymphadenectomy (R1 gastrectomy) were analysed retrospectively. Resection margins of all 46 consecutive patients were free from tumour. Tumours were limited to the mucosa in 35 patients and infiltrated the submucosa in 11. Positive lymph nodes were found in two patients. The 30-day mortality was two patients, and cardiac and pulmonary complications occurred in five and six respectively. Anastomotic leakage developed in two patients. During 5 years of follow-up two patients died from tumour recurrence; one of these had lymph node metastases at the initial resection. Resection with limited lymphadenectomy for early gastric cancer results in a 91 per cent 5-year survival rate without the need for R2 gastrectomy with its probably higher morbidity and mortality.
为评估R2胃切除术对早期胃癌患者的潜在益处，我们回顾性分析了接受传统有限淋巴结清扫切除术（R1胃切除术）患者的并发症及长期生存情况。连续46例患者的手术切缘均无肿瘤残留。35例患者肿瘤局限于黏膜层，11例浸润至黏膜下层。2例患者发现阳性淋巴结。30天内死亡2例，心脏和肺部并发症分别发生5例和6例。2例发生吻合口漏。在5年随访期间，2例患者死于肿瘤复发；其中1例在初次切除时已有淋巴结转移。早期胃癌行有限淋巴结清扫切除术可获得91%的5年生存率，无需进行可能具有更高发病率和死亡率的R2胃切除术。
