Impact Of Abdominal Aortic Lymph Node Dissection On The Survival Prognosis Of Patients With Advanced Gastric Cancer

Objective:Through a comparative study of the clinical effects of radical gastrectomy(D2)and D2 + abdominal aortic lymph node dissection(PAND)in advanced gastric cancer patients,whether D2 + PAND can improve the quality of life and prolong the patient.Survival period,an appropriate reference for clinical treatment.Methods:A total of 244 patients with gastric cancer in Shanxi Provincial People’s Hospital from January 2013 to January 2016 were selected.At the same time,emergency surgical procedures such as acute gastrointestinal perforation and major bleeding caused by gastric cancer before surgery were excluded,except for cases with incomplete clinical data.A total of 158 patients with measure up to were selected,including 90 patients who underwent gastric cancer D2 surgery as a control group(group D2)and 68 patients who underwent gastric cancer D2 + PAND surgery as an observation group(D2 + PAND group).The postoperative condition of the patients in the group was compared with the postoperative complications between the two groups.Since the selected patients undergoing gastric cancer D2 + PAND surgery were less than 5 years after surgery,the study between the two groups only had no effect on patients for the tumor-free survival rate at 1 and 3 years was compared with the survival rate at 1 and 3 years.Results:According to the statistical analysis of the data in the D2 group and the D2 + PAND group,there was no statistically significant difference in the incidence of surgery and postoperative complications between the two groups(P﹥0.05).The average of the operation time of group D2 and D2 + PAND were(297.5 ± 80.7)min and(344.7 ± 71.8)min,respectively,and the length of surgical incisions were(19.6 ± 4.4)cm and(23.3 ± 4.1)cm,respectively.All of them were statistically significant(P ﹤ 0.05),and there was no statistically significant difference between the two groups in terms of intraoperative blood loss,hospital stay,hospitalization cost(P﹥0.05).The 1-year and 3-year tumor-free survival rate in the D2 + PAND group was higher than that in the D2 group.The difference between the two groups was not statistically significant(P﹥0.05),and the difference in 1-year and 3-year survival rates between the two groups was not statistically significant(P﹥0.05)Conclusion:For the patients with gastric cancer in the D2 group and the D2 + PAND group,there is currently no significant difference in the 1-and 3-year survival rates,and further research is needed for large sample sizes.Although there was no significant difference in the 1-and 3-year tumor-free survival rates between the two groups,the D2 + PAND group had 10.5% and 11.5% higher tumor-free survival rates than the D2 group’s 1,3 tumor-free survival rates,respectively.There was no significant increase in the incidence of postoperative complications,length of hospital stay,hospitalization costs,and intraoperative blood loss in D2 + PAND surgery,but the D2 + PAND group was higher than the D2 group in terms of operation time and incision length,which may increase.The intraoperative risk and the chance of incision infection reduce the speed of incision healing.D2 + PAND surgery is more difficult than D2,so the level of the surgeon also affects the incidence of postoperative complications.The skilled surgeon also helps reduce the incidence of postoperative complications.Whether to recommend therapeutic PAND for patients with advanced gastric cancer is currently controversial worldwide,and further large-scale study is still needed.