D1 versus D2 dissection in stomach carcinoma: evaluation of postoperative mortality and complications
Veli Vural, Barış Saylam, Bülent Çomçalı, Arife Polat Düzgün, Mehmet Vasfi Özer, Faruk Coşkun
Clinic of 3rd General Surgery, Ankara Numune Training Hospital, Ankara, Turkey
Objective: Surgery is the only curative treatment for patients with gastric cancer. However, the extent of lymph node dissection is still debated. The aim of the study was to evaluate complications, postoperative stay and postoperative mortality after D1 or D2 lymph node dissection for gastric cancer when treated by surgery in a non-specialized hospital. Material and Methods: A retrospective review of all patients who underwent surgery for pathologically confirmed gastric cancer at our Clinic of 3rd General Surgery, Ankara Numune Education and Research Hospital between January 1999 and 2007 was conducted. A consecutive series of 71 gastric cancer patients was evaluated. D1 resection (level 1 lymphadenectomy) was compared with D2 resection (levels 1 and 2 lymphadenectomy). Results: The D2 group had greater postoperative hospital mortality (16% vs. 8%; p<0.005) and higher overall postoperative morbidity (54% vs. 34%; p<0.005); their postoperative stay was also longer. The excess postoperative morbidity and mortality in the D1 and D2 groups were not accounted for by splenectomy. Conclusion: The D2 procedure was associated with significantly higher postoperative mortality, morbidity, and postoperative stay.
Keywords: Mortality, morbidity, gastric cancer, surgery
Study concept and design - B.S., F.C., M.V.Ö.; Acquisition of data - V.V., B.Ç.; Analysis and interpretation of data - B.S., V. V., F. C.; Preparation of the manuscript - B.S., A.P.D., F.C.; Statistical analysis - V.V., B.S.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.