胃癌に対する中間区域切除術
D V Ruchkin1, M M Khamidov1, V A Kozlov1
1Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.
Objective. T:
O improve functional outcomes after surgical treatment of T1-2 gastric cancer.
Material And Methods:
The study included 11 patients (5 males, 6 females; mean age 73±8.6 years) with T1-2N0M0 gastric cancer who underwent middle segmental gastrectomy with D2 lymphadenectomy. Selection criteria included tumor localization in gastric body, resection margins ≥6 cm, confirmed by intraoperative endoscopy. Proximal and distal gastric stumps were formed with anti-reflux fundoplication cuff. Quality of life (QoL) was assessed using EORTC QLQ-C30 and STO22 questionnaires.
Results:
No postoperative complications or mortality were observed. Mean surgery time was 220.4±54.4 min, blood loss - 390±186.8 ml. All resections were radical (R0). In long-term period (24.2±17.5 months), recurrence occurred in 1 patient (T3N0M0). Reflux esophagitis was absent; mild dumping syndrome was detected in 1 patient. QoL scores after surgery (functional scale - 92.7; symptom scale - 23.8) surpassed those after gastrectomy, pylorus-preserving, and distal subtotal resections.
Conclusion:
Middle segmental gastrectomy demonstrates oncological adequacy and functional benefits (sphincter preservation, reduced reflux, and dumping syndrome). Further studies are required to confirm long-term outcomes.
