| Gastric cancer is one of the most common malignant tumors in China, its incidence and mortality rate tops the malignant tumors, the patients mainly locate in the southeast coastal areas, northwest and northeast, and in local area in the southwest. Compared with the earlier ages, there is a great progress in the prevention, diagnosis and treatment of the disease. Especially in the therapy, it has gradually formed a comprehensive treatment model,in which the surgical excision with variety of ways is the key point, companied with one of chemotherapy, radiotherapy or biological-immune therapy after the surgery. In the current circumstances, it is a growing consensus around the world that the surgical resection may be the only way to cure gastric cancer. D2 radical gastrectomy has gradually become the standard surgical treatment for early gastric cancer.However, with the progress and development in the society, the inevitable injury of vital organs from the surgery brought great pain to the patients, only simple biological treatment modalities could not meet the contemporary requirements for the medicine, that is, radical resection of the tumor, while reducing the risk of surgery and protecting the function of the organs. Vagus nerve-preserving radical gastrectomy had been proposed in this context and has been affirmed and promoted in the treatment of early gastric cancer. But for advanced gastric cancer, vagus nerve-preserving radical gastrectomy still lacks the support from randomized clinical trials on large sample and the evidence- based medicine in the following aspects:the radical extent of the tumor, the feasibility of surgical procedures and the protection of the function of vital organs after surgery.In order to improve the evaluation of the postoperative effects of vagus nerve-preserving radical gastrectomy in the treatment of advanced gastric cancer, this article selected 43 cases of patients with advanced gastric cancer from the general surgical disease centre in the Second Hospital of Jilin University from March 2009 to December 2009. Randomly divide them into treatment vagus nerve-preserving group and the traditional treatment D2 radical gastrectomy group. The patients in vagus nerve-preserving group underwent D2 radical gastrectomy while retain the vagus nerve, the traditional treatment group underwent D2 radical gastrectomy only. Patients were observed after the surgery in the first exhaust time, the first defecation time, the number of pathological lymph node dissection, etc. And the patients were followed up about whether experienced complications such as discomfort after eating or habitual diarrhea. The results were statistically analyzed (measurement data were analyzed by analysis of variance t test, count data were analyzed byχ2 test), evaluate the postoperative gastrointestinal motility after vagus nerve-preserving radical gastrectomy based on the results.This research indicates that for the advanced distal gastric cancer, the vagus nerve-preserving radical gastrectomy showed no significant difference in the radical extent of the tumor, compared with traditional D2 resection of gastric cancer. On the impact of the recent gastrointestinal motility in patients: compared to the traditional D2 resection of gastric cancer, the vagus nerve-preserving radical gastrectomy has lower incidence rate of the discomfort after postoperative eating. There was no significant difference on other recent impacts. Postoperative patients were followed up and we found that the vagus nerve-preserving radical gastrectomy was better than the traditional D2 radical gastrectomy in the long-term impact of gastrointestinal tract.Summing up all the research, we can reach the following conclusions: For the advanced distal gastric cancer, the vagus nerve-preserving radical gastrectomy shows no significant difference in radical resection of the tumor compared with the traditional radical resection of gastric cancer. The vagus nerve-preserving radical gastrectomy is superior to the traditional radical gastrectomy on the protection of the vital organ, the former one can improve the quality of life for patients after the operations, and it is worthy of promotion. However, since to guarantee the radical resection of the tumor while preserving the vagus nerve requires a higher operative technology for the surgeons, that the popularity of this technology should be based on the foundations that the surgeons should have a deep understanding of the technology and its indications and should have skilled applications of the very vessels and nerves. |
