[Vagus-saving D2 procedure for early gastric carcinoma]

Area of Science:

• Surgical Oncology
• Gastroenterology
• Minimally Invasive Surgery

Context:

• Early gastric carcinoma treatment often involves aggressive lymph node dissection (D2).
• Conventional D2 dissection can lead to a reduced quality of life post-surgery.
• Vagus nerve preservation is a key factor in post-gastrectomy recovery.

Purpose:

• To introduce and evaluate the efficacy of a novel nerve-saving D2 (VS-D2) surgical procedure.
• To compare the quality of life outcomes of VS-D2 with conventional D2 dissection.
• To assess the oncological safety and postoperative complications of VS-D2.

Summary:

• The nerve-saving D2 (VS-D2) procedure involves D2 lymph node dissection while preserving the hepatic and celiac branches of the vagus nerve.
• A study of 39 patients undergoing VS-D2 showed no operative deaths or recurrence.
• VS-D2 demonstrated a significantly lower incidence of postoperative diarrhea (3% vs. 28%) and a trend towards better weight regain compared to conventional D2.

Impact:

• VS-D2 offers a viable alternative for early gastric carcinoma surgery, maintaining oncological outcomes.
• The procedure significantly enhances patient quality of life by mitigating common postoperative morbidities.
• This approach represents an advancement in surgical techniques for gastric cancer, prioritizing patient well-being alongside curative intent.