Outcome of pylorus-preserving gastrectomy for early gastric cancer

Background: Pylorus-preserving gastrectomy has been introduced as a function-preserving operation for early gastric cancer in Japan. The aim of this study was to investigate the safety and radicality of the procedure. Methods: Between 1995 and 2004, 611 patients with apparent early gastric cancer in the middle third of the stomach had pylorus-preserving gastrectomy. The short-term surgical and long-term oncological outcomes of these operations were assessed. Results: The accuracy of preoperative diagnosis of early gastric cancer was 94.3 per cent. Nodal involvement was seen in 62 patients (10.1 per cent). There were no postoperative deaths. Complications developed in 102 patients (16.7 per cent). Major complications, such as leakage and abscess, were observed in 19 (3.1 per cent). The most common complication was gastric stasis, occurring in 49 (8.0 per cent). The overall 5-year survival rate in patients with early gastric cancer was 96.3 per cent. Conclusion: Pylorus-preserving gastrectomy is a safe operation with an excellent prognosis in patients with early gastric cancer. It is recommended as the standard procedure for early gastric cancer in the middle third of the stomach.