Abstract:

Objective

To explore the application effect of complete mesocolic excision based on membrane anatomy+D2 radical resection in the treatment of advanced gastric cancer.

Methods

The case data of 175 patients with advanced gastric cancer from June 2020 to February 2023 were retrospectively analyzed.According to different surgical procedures，they were divided into the control group （receiving only D2 radical surgery，n=86 cases） and the observation group （receiving complete mesocolic excision based on membrane anatomy+D2 radical resection，n=89 cases）.The statistical software SPSS 25.0 was used for data processing.Perioperative indexes and gastrointestinal function were expressed as （±s），and independent sample t test was used between groups； Count data such as postoperative complications were expressed as［ cases（%）］，and χ² test was performed； The Kaplan-Meier method was used to statistically analyze the recurrence risk function of advanced gastric cancer.A P value＜0.05 was considered statistically significant.

Results

The intraoperative blood loss of patients in the observation group was less than that in the control group，the number of lymph node dissections during the operation was more than that in the control group，and the recovery time of bowel sounds after the operation was shorter than that in the control group （P＜0.05）.Seven days after the operation，the levels of motilin and gastrin in both groups increased，and those in the observation group were higher than those in the control group.The level of diamine oxidase （DAO） decreased，and that in the observation group was lower than that in the control group （P＜0.05）.There was no significant difference in the incidence of postoperative complications between the two groups （P＞0.05）.Twelve months after the operation，the recurrence rate of patients in the observation group was lower than that in the control group （6.7% vs.16.3%，P=0.047）.The median recurrence time of patients in the observation group was 7.5 （5.8，9.5） months，which was lower than 6.5 （5.0，9.3） months in the control group （P=0.046）.

Conclusion

Applying complete mesocolic excision based on membrane anatomy + D2 radical resection to patients with advanced gastric cancer can reduce intraoperative blood loss，increase the number of lymph node dissections，accelerate the recovery of gastrointestinal function after the operation，and reduce the recurrence risk of gastric cancer，with a good application effect.

Key words: Stomach Neoplasms, Progress Period, Gastrectomy, Complete Mesangial Resection Surgery, Gastrointestinal Function, Recurrence