The Clinical Effect Observation Of D3 Lymph Node Dissection In Radical Gastrectomy For Progressive Gastric Cancer

Objective:To study the application of D3 dissection in surgery according to the results which come from the observation of the quality of life,the partial recurrence rate and the survival rate of the patients who underwent the D3 radical operation of gastric cancer and the comparison of these parameters between those who underwent the D2 and D3 radical operation.Methods:Analyse the clinical cases of 139 patients with gastric cancer who underwent operation in our hospital during September 2005 to September 2006.67 of them underwent D3 radical operation in our hospital(Group A),the other 72 patients underwent the D2 radical operation in our hospitals(Group B).They all belong to stageⅡ-Ⅲaccording to the PTNM staging standard。All the patients here received the operation as their first one to cure the cancer。Compare the duration of the operation,intraoperative blood loss,length of stay,time of recovery of gastrointestinal function after surgery,number of lymph node metastasis,partial recurrence rate and survival rate of two groups。Results:①The differences in gender,age,pathological staging,size of tumor and the stage of tumor between the two groups were not statistically significant(P>0.05).②The differences in intraoperative blood loss,time of recovery of gastrointestinal function after surgery,length of stay between the two groups were not statistically significant(P>0.05).But the numbers of lymph node metastasis were quite different.③There was not obvious differency in 2-year survival rates between two groups,but the 3-year,4-year and 5-year survival rate were differen(t65.3% vs. 70.1%,59.7% vs. 65.7%,38.8% vs. 53.7%)(P < 0. 05)。13.5% of Group A and 8.6% of Group B had the complications after the operations,this statistic was not statistically significant(P > 0. 05),only the durations of operation between the two groups were different.Conclusion:D3 lymph node dissection can improve the prognosis and quality of life for the patients with advanced gastric cancer.Most patients with gastric cancer in our country belong to stageⅡ-Ⅳ,so D3 lymph node dissection is feasible for those who have poorly differentiated or deeply infiltrated tumor cells ,no matter what size the tumor is. Furthermore, D3 radical operation is better than D2 lymph node dissection for those patients.