Phase II Study of Limited Surgery for Early Gastric Cancer: Segmental Gastric Resection

Background: Endoscopic resection for treatment of early gastric cancer (EGC) is widely performed. Recently, however, surgeons began performing a limited operation for EGC when endoscopic resection was not indicated. This report discusses the surgical technique and the results of the limited operation, which is generally referred to as segmental resection (SR).Methods: Since 1990, a total of 50 patients with intramucosal invasive EGC of the middle stomach underwent SR. The procedure included a limited gastrectomy, limited lymph node dissection, and preservation of the vagal nerve. We examined the surgical risk, postoperative complications, and patient survival rates and compared the results for the SR-treated patients (group A) with results for patients with EGC who underwent subtotal gastrectomy and systemic lymph node dissection (group B).Results: Blood loss was less in group A (239±180 ml) than in group B (342±176 ml) (P<.05). The incidence of postoperative complications was also lower in group A (2.0%) than in group B (14.0%) (P<.05). The incidence of postoperative cholelithiasis was lower in group A (4.0%) than in group B (18.0%) (P<.05). All patients in both groups are alive without recurrence.Conclusions: Compared with distal gastrectomy, SR for EGC of the middle stomach decreased the surgical risk and postoperative complications without increasing the recurrence rate.Supported by a Grant-in-Aid for Cancer Research (9–3) from the Ministry of Health and Welfare, Japan.