The Clinical Significance of Gastrectomy with Preservation of Autonomic Nerves and the Pylorus Accompanied with D₂ Dissection for Early Gastric Cancer

Motoki Ninomiya, Toshiyuki Ikeda, Hikaru Asakura, Youki Moriyama, Tadashi Onoda, Shigehiro Shiozaki, Satoshi Ohno, Kenji Higaki, Naohiro Kobayashi, Shinsuke Okamura

Department of Surgery, Hiroshima City Hospital

We have applied a gastrectomy with preservation of both the autonomic nerves and the pylorus accompanied with D₂ dissection for early gastric cancer located in the middle or lower thirds of the stomach. We performed this procedure for 41 cases between December 1993 and December 1995. There was no case of dumping syndrome, reflux esophagitis, anastomotic leakage, postoperative cholelithiasis or recurrence of cancer. Mortality was observed in no case. Thogh prolongation of gastric emptying was observed in more than half of cases and the symptom of gastric stasis was observed in 12 cases (29.3%), most of them were transient. X-ray and gastrointestinal fiberscopic examination revealed that pyloric function and peristalsis of antrum were kept well six mothes after operation. Furthermore, recovery of the body weight was superior three months after operation in this procedure group comparing conventional distal gastrectomy group. We conclude that this function preserving operation is a rational approach to mainining curability and the function of upper abdominal organs after gastrectomy.

Key words
pylorus preserving gastrectomy, autonomic nerves, early gastric cancer, function preserving gastrectomy

Reprint requests
Motoki Ninomiya Department of Surgery, Hiroshima City Hospital
7-13 Motomachi, Nakaku, Hiroshimashi, 730 JAPAN

Accepted
September 9, 1997

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