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J.Jpn. Surg. Soc.. 97(4): 286-290, 1996
Feature topic
VAGUS-SAVING D2 PROCEDURE FOR EARLY GASTRIC CARCINOMA
To improve quality of life in patients who had an aggressive lymph nodes dissection (D
2) for early gastric carcinoma, we developed a novel procedure, nerve-saving D
2 (VS-D
2), in 1991. This procedure constitutes D
2 and saving of hepatic and celiac branches of the vagus nerve, whereas conventional D
2 consists of D
2 and preserving hepatic branches alone of the vagus nerve. Thirty-nine patients between 1991 and 1994 who received VS-D
2 and included 3 cases with nodal involvement had no operative death and no recurrence. The occurrence rate of postoperative diarrhea in patients with VS-D
2 significantly lower than that in patients with conventional D
2 (3％ versus 28％, p< 0.01). Postoperative incomplete weigth regain (less than 95％ of preoperative weight) was also relatively lesser in patients with VS-D
2 than those with conventional D
2 (64％ versus 84％, p＝0.08). The incidence of formation of gallstone also was relatively Iow in patients with VS-D
2 compared that in those with conventional D
2 (3％ versus 13％) though the difference was not statistically significant. These results suggest that VS-D
2 keeps curability of conventional D
2 and improves quality of life in patients following surgery for early gastric carcinoma.
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