title: [Efficacy analysis of laparoscopy-assisted pylorus-vagus nerve preserving gastrectomy in the treatment of early middle gastric cancer].
abstract: OBJECTIVE
  To compare the efficacy and safety of laparoscopy-assisted pylorus-vagus nerve preserving gastrectomy (LAPPG) and laparoscopy-assisted distal gastrectomy (LADG) in order to evaluate the feasibility of LAPPG in the treatment of early middle gastric cancer.
  
  
  METHODS
  Clinical and follow-up data of 60 patients with early middle gastric cancer undergoing laparoscopic operation in The First Affiliated Hospital of Dalian Medical University from September 2003 to July 2010 were analyzed retrospectively, including 35 patients with LAPPG and 25 with LADG. Operation time, blood loss, postoperative complications, postoperative nutritional status and long-term survival were compared between two groups.
  
  
  RESULTS
  There were no significant differences in baseline information between the two groups. Distal resection margin distance of LAPPG group was significantly shorter than that of LADG group [(2.64±1.29) cm vs. (4.66±2.01) cm, P=0.001], while operative time, blood loss, and number of harvested lymph node were not significantly different between the two groups (all P>0.05). In LAPPG group, ratio of delayed gastric emptying was significantly higher [28.6%(10/35) vs. 8.0%(2/25), P=0.046] and ratio of acid reflux was significantly lower [0 vs. 20.0%(5/25), P=0.038] as compared to LADG group, while postoperative complications, body weight and serum albumin level were not significantly different between the two groups (all P>0.05). Postoperative overall 5-year survival rate was 91.1% and 90.3% in LAPPG and LADG group respectively without significant difference (P=0.704).
  
  
  CONCLUSIONS
  LAPPG can effectively control the velocity of postoperative gastric emptying and decrease gastric reflux without affecting oncologic efficacy, which is a good choice in the treatment of early middle gastric cancer.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian 116011, China. surgeon_zc1978@sina.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Hu
authors.forename: Chi
authors.initials: C
authors.lastname: Zhang
authors.forename: Liang
authors.initials: L
authors.lastname: Cao
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
mesh_terms: D055088:Early Detection of Cancer; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux; D018589:Gastroparesis; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008198:Lymph Nodes; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011184:Postoperative Period; D011708:Pylorus; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D014630:Vagus Nerve