title: Comparing the short-term outcomes of laparoscopic distal gastrectomy with D1+ and D2 lymph node dissection for gastric cancer.
abstract: BACKGROUND
  Laparoscopic distal gastrectomy (LDG) with D1+ lymph node dissection (LND) for early gastric cancer has been widely accepted. However, LDG with D2 LND for advanced gastric cancer remains in limited use. The aim of this retrospective study was to clarify the safety of LDG with D2 LND for gastric cancer.
  
  
  METHODS
  From January 2010 to September 2014, 296 patients underwent LDG; those who received D1+ LND (n = 230) or D2 LND (n = 66) were included in this study. The clinicopathological characteristics and short-term outcomes of both groups were investigated and compared.
  
  
  RESULTS
  There were no significant differences in the incidence of postoperative complications between the two groups. However, the frequency of infectious intra-abdominal complications was higher in the D2 LND group than in the D1+ LND group. Additionally, a lower risk of infectious intra-abdominal complications was seen with certified than with uncertified operators.
  
  
  CONCLUSIONS
  The evaluation of short-term outcomes demonstrated that LDG with D2 LND is generally feasible. However, the risk of infectious intra-abdominal complications is higher with D2 LND than with D1+ LND. Also, D2 LND should be performed by trained operators.
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Goto
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yasuda
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Oshikiri
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kanaji
authors.affiliation: Division of Surgery, Kobe Rosai Hospital, Kobe, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kawasaki
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Imanishi
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Oyama
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Kakinoki
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Ohara
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Sendo
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tominaga
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: D1+ lymph node dissection; D2 lymph node dissection; gastric cancer; laparoscopic distal gastrectomy