[Rational evaluation of different lymph node dissection]

To evaluate the effect and indication of different lymph node dissection (D1+, D2, D3), we performed radical operations for 371 cases of gastric cancer. The results showed that D1+ or D1 lymph node dissection was enough for gastric cancer of Ia stage, D2 was suitable for Ib stage. For localized or massive type gastric cancer of II + III stage, D3, D2 dissection was better than D1+ dissection. For the gastric cancer of the same type in IV stage, the 5-year survival rate after D3 + D2 dissection was 42.9%, but for the gastric cancer of infiltrative type or diffused growth pattern in II + III stage, the effect was not significantly increased even after the D3, D2 dissection. For the gastric cancer of this type in IV stage, the effect was not improved after the extended lymph node dissection. Extended dissection needn't be performed if there was no lymph node metastasis. D3, D2 dissection was better if there was little lymph node metastasis or the metastasis was limited to 1st group. For those metastasized to 2nd group or the quantity was more, D3 was better than D2, D1+. The effect of D3, D2 dissection was not significantly improved in the extensive metastasis case (more than 10 or to the 3rd group).