Objective: To compare the long-term survival and the postoperative complication morbidity of distal gastric cancer patients between distal gastrectomy (DG) and total gastrectomy (TG).
Methods: Clinicopathological data of 1140 patients with distal gastric cancer undergoing curative gastrectomy from May 2008 to April 2015 were analyzed retrospectively. A total of 992 patients underwent DG (207 patients of Billroth I( and 785 of Billroth II() and 148 patients underwent TG. Patients between the DG and TG group were selected using gmatch methods based on tumor size(±1 cm), differentiated degree and depth of invasion in order to reduce the differences in clinicopathological characteristics.
Results: Compared with TG group, the DG group had significantly shorter operation time (198.8 min vs. 236.0 min, P=0.001), less blood loss (197.1 ml vs. 252.8 ml, P=0.033), and shorter postoperative hospital stay (7.8 days vs. 8.5 days, P=0.036). However, the postoperative complication morbidity and mortality were not significantly different between the two groups (P>0.05). The 3-year survival rate was significantly higher in the DG group compared to the TG group (74.4% vs. 58.7%, P=0.013).
Conclusions: Compared with TG, DG has a comparable safety and a better long-term survival. DG should be considered as the optimal choice for patients with distal gastric cancer.