Enbloc Mesogastric Excision And Clinical Comparative Analysis Of D₂ Radical Prostatectomy

Objective: by comparing the enbloc mesogastric excision and gastric D₂ radical surgery, to evaluate the feasibility and safety of enbloc mesogastric excision.Methods: collection of the Department of gastrointestinal surgery the second hospital of jilin university January 2010 to January 2013,100 cases accepted surgical treatment of gastric cancer data, 50 cases accept enbloc mesogastric excision,50 cases accept traditional surgery, comparing with the average amount of bleeding, the number of lymph nodes, the average operation time, postoperative complications, transfusion rate and mortality,Recurrence metastasis rate。.Results: the results in Table 2 can be seen throughout the enbloc mesogastric excision group, the average amount of bleeding was246±29.6ml,less than the D₂ group352±28.6ml（P<0.01）.Two groups were significantly different. The enbloc mesogastric group the number of lymph nodes was20.7±2.3, more thano D₂ group,which is 14.5±2.2（P<0.01）, the two groups have significant difference. Blood transfusion rate difference between the two groups was not statistically significant（P > 0.05）.And enbloc mesogastric group lost to follow-up 2 cases, D₂ resection group was lost to follow-up in 3 cases, Enbloc mesogastric excision group mortality lower than D₂ surgery group（P < 0.05）. enbloc mesogastric excision group, the mean operation time was 158±5.0min,shorter than D₂ group 182.5±6.9min（P < 0.01）, the two groups have significant difference. Enbloc mesogastric excision group recurrence and metastasis rate lower than D₂ surgery group（P < 0.05）, the two groups with significant differences. Complications of enbloc mesogastric group with 3 cases of incision infection, 2 cases of pulmonary infection, 1 cases duodenal stump external fistula, D₂ resection group with 4 cases of incision infection, 2 cases of duodenal stump external fistula, 2 cases of anastomotic bleeding, there was no statistically significant difference（P > 0.05）.Conclusion: 1. The EME in line with the principle of radical resetion of gastric cancer, and is safe and feasible.2. To compared with traditional D₂ surgery, advantages is the average amount of bleeding is less, more cleaning the lymph node Numbers, Average operation time is short,mortality is low. Low transfer of recurrence rate advantages.3. The EME embryology and anatomy as a foundation, could be seen as a total mesorectum excision（TME） and the continuation of the complete mesocolic excision（CME）.4. The EME formed the third radical principle, prevent the fifth metastatic cancer cells scattered in the surgical field.5. Surgery plus chemotherapy（XELOX） can improve the prognosis of patients.