Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14927
Revised: May 15, 2014
Accepted: July 22, 2014
Published online: October 28, 2014
AIM: To study the effect of somatostatin in patients with advanced gastric cancer who received D2 lymphadenectomy and vagina vasorum dissection.
METHODS: Using a prospective, single-blind, placebo-controlled design, patients with advanced gastric cancer were randomized into a study group (n = 61) and a control group (n = 59). Patients in the study group were given somatostatin for 5-7 d starting 6 h after the operation, and patients in the control group were given normal saline. Preoperative and nonoperative complications in the perioperative period, as well as different types of postoperative drainage in the two groups were compared.
RESULTS: There was no significant difference between the study group and the control group for preoperative clinicopathological indicators. We found no significant difference between the two groups for the overall incidence of complications, but a lower percentage of peritoneal effusion was observed in the treatment group (1.6% vs 10.2%, P < 0.05). There were no significant differences between the two groups in the incidence of postoperative pancreatic dysfunction and chylous fistula. However, there were significant differences in the amylase concentration in drainage fluid, volume and duration of drainage, volume and duration of chylous fistula and peritoneal drainage, and volume and duration of gastric tube drainage. The study group did not show any increase in mean hospitalization cost and the cost reduced when the postoperative complications occurred.
CONCLUSION: Postoperative somatostatin reduces volume and duration of surgical drainage and related complications. Somatostatin may improve safety of gastric cancer surgery, reducing postoperative complications and promoting recovery.
Core tip: To enhance the degree of radical lymph nodes dissection for advanced gastric cancer, vagina vasorum dissection and the resection of extracapsular greater omentum was applied to D2 lymph node dissection. Vagina vasorum dissection was the complete removal of vascular adventitia and fibrous connective tissue as well as nerve tissue around the vascular sheath. But these procedure usually followed by operation-related complications. Hence It is interesting to found out the clinical effect of postoperative somatostatin treatment in the duration and amount of drain followed by gastrectomy and D2 lymphadenectomy with extra capsular epiploon resection.