1. Complete mesogastric excision for locally advanced gastric cancer: short-term outcomes of a randomized clinical trial.
- Author
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Xie D, Shen J, Liu L, Cao B, Wang Y, Qin J, Wu J, Yan Q, Hu Y, Yang C, Cao Z, Hu J, Yin P, and Gong J
- Subjects
- Adult, Blood Loss, Surgical physiopathology, Blood Loss, Surgical prevention & control, Disease Progression, Female, Flatulence diagnosis, Flatulence etiology, Flatulence physiopathology, Humans, Lymph Nodes pathology, Male, Mesentery pathology, Middle Aged, Odds Ratio, Patient Safety, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Stomach pathology, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Survival Analysis, Treatment Outcome, Gastrectomy methods, Lymph Node Excision methods, Lymph Nodes surgery, Mesentery surgery, Stomach surgery, Stomach Neoplasms surgery
- Abstract
Implementation of complete mesogastric excision in gastric cancer surgery, named D2 lymphadenectomy plus complete mesogastric excision (D2+CME), has recently been proposed as an optimal procedure. However, the safety and efficacy of D2+CME remain uncertain. In this randomized controlled trial, patients receiving D2+CME exhibit less intraoperative blood loss, more lymph node harvesting, and earlier postoperative flatus than patients receiving conventional D2 radical surgery. Univariate Cox regression analysis reveals that the risk ratio for postoperative flatus in D2+CME group is 1.247 (p = 0.044). Overall postoperative complications are comparable between the two groups, but complications are significantly less severe in the D2+CME group than the D2 group (Clavien-Dindo classification grade ≥ IIIa: 4 D2+CME patients [11.8%] versus 9 D2 patients [33.3%]; p = 0.041). In conclusion, our work shows that D2+CME is associated with better short-term outcomes and surgical safety than conventional D2 dissection for patients with advanced gastric cancer., Competing Interests: The authors declare no competing interests., (© 2021 The Authors.)
- Published
- 2021
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