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Extended lymphadenectomy (D2) in the treatment for gastric cancer: analysis of postoperative complications

BACKGROUND: The aim of this study was to describe and analyze the postoperative complications and the survival of patients submitted to gastric resection with extended lymphadenectomy. METHODS: In a historical cohort, data of patients with gastric carcinoma submitted to D2 lymphadenectomy were studied. The main variables analyzed were: age, tumor location, stage, surgical procedure complications, pattern of tumor recurrence and overall survival. RESULTS: Thirty-five patients were studied during the period between January 2000 and December 2004. Mean age of the patients was 57 years. Only one (2.9%) patient had early gastric cancer. The most common site was in the middle-third of the stomach. The number of resected nodes per patient ranged from 15 to 80 (mean of 28.8). Twenty-six (74.3%) patients had metastatic lymph nodes, with mean of 13.4 (±11.8) positive nodes per patient. Six (17.1%) patients had complications in the postoperative period, including two pneumonias, one pancreatic fistula, one duodenal stump fistula, and two esophagojejunal leakage. Only one (2.86%) patient died of operative complications. The meantime of follow-up was 26 months. Twenty-two patients were alive at the conclusion of the study, with a current actuarial survival of 62.9%. CONCLUSION: The results of this study suggest that, in specialized centers, gastrectomy with D2 lymphadenectomy is a procedure with acceptable levels of complications, and can be performed without increasing the postoperative mortality.

Lymph Node Excision; Gastrectomy; Stomach Neoplasms; Postoperative Complications


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