title: [Application of pylorus-vagus-preserving gastrectomy in early gastric cancer in middle third of stomach].
abstract: OBJECTIVE
  To evaluate the long-term outcomes of pylorus-vagus-preserving partial gastrectomy for early gastric cancer in middle third of stomach.
  
  
  METHODS
  Between January 2004 and June 2009, 46 patients with early gastric cancer in middle third of stomach underwent pylorus-vagus-preserving partial gastrectomy (PPG) while another 85 patients had conventional distal gastrectomy (DG). Clinicopathologic data and follow-up results of two groups were analyzed retrospectively, including the results of subjective nutritional assessments, laboratory blood biochemical data, endoscopic findings of remnant stomach and total 5-year survival rates.
  
  
  RESULTS
  Postprandial dumping syndrome occurred in 7 patients (8.2%) in DG group while no syndrome occurred in PPG group. The incidence of gallbladder stones at 18 months after operation in DG group was higher than that in PPG group. Significant difference existed between two groups (P<0.05). Even though no significant difference existed in laboratory blood biochemical data and endoscopic findings, PPG group recovered better and regurgitation was frequently found in DG group. Food residue in gastric remnant was frequently observed in PPG (31.1%) than in DG (10.8%, P<0.05) by endoscopic findings. At 2 years post-operation, the postoperative 5-year recurrence rate was 6.5% (2/46) in PPG group versus 8.2% (7/85) in DG group. However no significant difference existed between 2 groups (P=0.724). No significant difference existed between PPG group (91.3%) and DG group (90.6%) in overall 5-year survival rate.
  
  
  CONCLUSIONS
  For early gastric cancer in middle third of stomach, pylorus-vagus-preserving partial gastrectomy is effective in maintaining postoperative function. And it has the same postoperative survival rate as conventional distal gastrectomy.
authors.affiliation: Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China; Email: zhumf@hzswdx.gov.cn.
authors.forename: Qinshu
authors.initials: Q
authors.lastname: Shao
authors.affiliation: Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Yuanshui
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Xu
mesh_terms: D055088:Early Detection of Cancer; D042882:Gallstones; D005743:Gastrectomy; D018530:Gastric Stump; D006801:Humans; D015994:Incidence; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D019518:Postprandial Period; D011708:Pylorus; D012189:Retrospective Studies; D013274:Stomach Neoplasms; D014630:Vagus Nerve