Near-and medium-term follow-up study of complete mesangectomy plus standard D2 radical resection for advanced gastric cancer

doi:10.3877/cma.j.issn.1674-3946.2025.01.009.

Abstract

Abstract:

Objective

To investigate the short and medium term efficacy of complete mesangectomy（CME） plus standard D2 radical resection for advanced gastric cancer.

Methods

A total of 130 patients with advanced gastric cancer from January 2019 to December 2020 were selected and divided into study group（CME+D2） and control group （D2 radical resection） by random munber table method， with 65 patients in each group.SPSS 25.0 software was used for data analysis， and measurement data such as perioperative indicators were expressed with （x ± s）.Independent sample t test； The complication rate and other statistical data were measured by χ² test.Survival analysis was tested by Kaplan-Meier method in parallel with Log-Rank.P＜0.05 was considered statistically significant.

Results

The operative time and blood loss in the study group were less than those in the control group， and the number of lymph nodes dissection was more than that in the control group （P＜0.05）.The first postoperative exhaust time， the time of getting out of bed and the time of hospitalization in the study group were shorter than those in the control group （P＜0.05）.The total incidence of postoperative complications in the study group was 4.6% （3/65） lower than that in the control group （15.4%（10/65）（P＜0.05）.The 1-year and 3-year follow-up local recurrence rate of the study group was lower than that of the control group， the overall survival rate was higher than that of the control group， and the 1-year and 3-year follow-up progression-free survival （PFS） and overall survival （OS） were longer than those of the control group （P＜0.05）.

Conclusion

The application of CME+D2 in the treatment of advanced gastric cancer promotes postoperative recovery of patients， has significant effects on shortening operation time， reducing intraoperative blood loss， thorough dissection of lymph nodes， and can reduce the incidence of complications，which is conducive to reducing local recurrence 1 and 3 years after surgery， improving the overall survival rate of patients， and prolonging PFS and OS in the near and medium term.

Key words: Stomach Neoplasms, Complete Mesogastric Excision, D2 Radical Surgery, Neoplasm Recurrence, Local, Postoperative Complications

Shijun Liu, Jie Ma, Lujing Shi. Near-and medium-term follow-up study of complete mesangectomy plus standard D2 radical resection for advanced gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 27-30.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2025.01.009.

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Figures/Tables 6

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	肿瘤部位（例）A/B/C/D	肿瘤分期（例）Ⅱ/Ⅲ	最大肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）
研究组	65	63.3±3.1	40/25	19/9/10/27	29/36	4.7±1.0
对照组	65	63.0±3.0	36/29	17/8/8/32	26/39	4.7±1.1
t/χ²值		0.511	0.507	0.816	0.284	0.107
P值		0.610	0.477	0.846	0.594	0.915

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	肿瘤部位（例）A/B/C/D	肿瘤分期（例）Ⅱ/Ⅲ	最大肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）
研究组	65	63.3±3.1	40/25	19/9/10/27	29/36	4.7±1.0
对照组	65	63.0±3.0	36/29	17/8/8/32	26/39	4.7±1.1
t/χ²值		0.511	0.507	0.816	0.284	0.107
P值		0.610	0.477	0.846	0.594	0.915

组别	例数	手术时间（min）	术中出血量（ml）	淋巴结清扫数（枚）
研究组	65	173.4±30.3	72.2±15.9	24.5±5.6
对照组	65	192.0±40.9	113.2±26.1	21.5±5.3
t值		2.941	18.803	3.143
P值		0.004	＜0.001	0.002

组别	例数	术后首次排气时间（h， $\overset{ˉ}{x}$ ±s）	下床活动时间（h， $\overset{ˉ}{x}$ ±s）	住院时间［d，M（P₂₅，P₇₅）］
研究组	65	59.2±6.9	34.2±5.0	10.0（9.0，11.0）
对照组	65	68.5±7.1	36.1±4.7	12.0（11.0，13.0）
t/Z值		7.561	2.254	7.789
P值		＜0.001	0.026	＜0.001

组别	例数	术后首次排气时间（h， $\overset{ˉ}{x}$ ±s）	下床活动时间（h， $\overset{ˉ}{x}$ ±s）	住院时间［d，M（P₂₅，P₇₅）］
研究组	65	59.2±6.9	34.2±5.0	10.0（9.0，11.0）
对照组	65	68.5±7.1	36.1±4.7	12.0（11.0，13.0）
t/Z值		7.561	2.254	7.789
P值		＜0.001	0.026	＜0.001

组别	例数	胃出血	胃肠功能紊乱	切口感染	吻合口漏	总并发症
研究组	65	1（1.5）	1（1.5）	1（1.5）	0（0.0）	3（4.6）
对照组	65	2（3.1）	4（6.2）	3（4.6）	1（1.5）	10（15.4）
χ²值		-	-	-	-	4.188
P值		-	-	-	-	0.041

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