title: Long-term clinical outcome and survival after pylorus-preserving gastrectomy.
abstract: OBJECTIVE
  Pylorus-preserving gastrectomy (PPG) was introduced as a function preserving and minimally-invasive surgery for early gastric cancer (ECG). We investigated the long-term clinical and oncological outcomes of the procedure.
  
  
  METHODS
  A total of 433 patients who underwent PPG between 1993 and 2009 were assessed retrospectively.
  
  
  RESULTS
  The accuracy of the preoperative diagnosis of EGC was 93.1%. The incidence of lymph node metastasis was 3.7%. The median follow-up period was 77 (9-201) months. The overall 5-year survival rate was 96.6%. Three patients with advanced cancer developed recurrence and died. Thirteen patients developed a second primary gastric cancer in the remnant stomach. Four patients were treated by endoscopic resection, and nine underwent gastrectomy all with curative intent. The incidence of regurgitation and gastric-fullness at 5 years after PPG were 6.1% and 1.5%. Endoscopic findings of residual food, gastritis, bile reflex and reflux esophagitis were 19.1%, 11.0%, 3.0%, 10.0%, respectively. The mean relative body weight recovered up to 94.0% of that prior to surgery after 1 year and maintained.
  
  
  CONCLUSIONS
  PPG is a safe operative procedure for patients with EGC. It is important to improve the accuracy of preoperative diagnosis, and patients should be carefully followed-up to detect remnant stomach cancer.
authors.affiliation: Division of Surgery, Niigata Cancer Center Hospital, Niigata, Japan. matsukia@niigata-cc.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsuki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nashimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yabusaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D018530:Gastric Stump / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011708:Pylorus / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult