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D2 gastrectomy -- a safe operation in experienced hands.

R S Date1, K J S Panesar

  • 1Department of Surgery, Altnagelvin Area Hospital, Londonderry, UK.

International Journal of Clinical Practice
|June 1, 2005
PubMed
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D2 gastrectomy with splenectomy and distal pancreatectomy is a safe surgical approach for gastric cancer. This study found acceptable postoperative morbidity and mortality rates in experienced hands.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Surgery remains the only potentially curative treatment for gastric cancer.
  • Surgical resection extent for gastric cancer lacks consensus.
  • D2 gastrectomy offers benefits in morbidity, mortality, recurrence, and survival.

Purpose of the Study:

  • To evaluate the safety and outcomes of D2 gastrectomy with splenectomy and distal pancreatectomy in gastric cancer patients.
  • To assess postoperative morbidity and mortality associated with this specific surgical approach.

Main Methods:

  • Retrospective review of 33 patients undergoing D2 gastrectomy with splenectomy and distal pancreatectomy for gastric carcinoma.
  • Data collected from January 1995 to December 2000.
  • Evaluation of postoperative complications, including morbidity, mortality, and anastomotic issues.

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Main Results:

  • Postoperative morbidity was 18% and mortality was 9%.
  • No anastomotic leaks were observed.
  • Dysphagia occurred in 9% of patients, with 6% requiring dilatation for anastomotic stricture.

Conclusions:

  • D2 gastrectomy combined with splenectomy and distal pancreatectomy is a safe elective procedure when performed by experienced surgeons.
  • Circular staplers facilitate safe esophagojejunal anastomosis.