Application of pylorus-preserving gastrectomy in surgical treatment for early gastric cancer and interpretation of guidelines and consensus

Abstract

Endoscopic resection (ER) and laparoscopic surgery are the main methods for treatment of early gastric cancer (EGC). Radical gastrectomy(RG) and lymph node dissection are required for the patients who don’t meet the indications of ER, but it may cause postoperative stomach dysfunction and reduce quality of life (QOL). Pylorus-preserving gastrectomy (PPG) is one of the function-preserving gastrectomy for EGC. The short-term complications of PPG are equal to that of RG and it is also beneficial to long-term nutritional status and QOL. The 5-year survival rate of PPG is similar to that of distal subtotal gastrectomy (DSG) according to a retrospective study of the matched cohort. But delayed gastric emptying (DGE) is a common problem in the short and long term after PPG. The limited lymph node dissection of PPG makes its application not widely promoted. Sentinel node navigation surgery (SNNS) may provide more personalized and minimally invasive surgery, in order to preserve the gastric function to the maximum extent.

Keywords

• |early gastric cancer|pylorus-preserving gastrectomy|delayed gastric emptying|lymph node dissection