B. A. Borraez-Segura1,2, R. Oliveros1, O. Guevara1, M. E. Manrique1, I. D. Martin2, B. A. Borraez-Segura1,2 1Instituto Nacional De Cancerologia,Gastrointestinal Surgery And Digestive Endoscopy,Bogota, BOGOTA, Colombia 2Fundación Clinica Shaio,General Surgery,Bogota, BOGOTA, Colombia
Introduction: Surgical expertise is the perfect match between theory and practice in surgery. For surgeons, nodal dissection improves survival in patients with diagnosis of gastric cancer, but the proper procedure requires the proper surgical and academic skills. Even being clear that D2 dissection is the standard of treatment, the number of nodes is a representation of the optimal treatment for gastric cancer and is directly associated with surgical expertise. The aims of this study were to determine: (a) the number of nodes dissected during a total and subtotal gastrectomy by general and by gastrointestinal surgeons; and (b) how often a proper nodal dissection was performed by the two groups.
Methods: Review of a prospectively set database. We compare the pathology report of 144 patients who underwent total or subtotal gastrectomy for gastric cancer in terms of nodal dissection for general (Group A) and gastrointestinal surgeons (Group B).
Results: In 58 of the 144 patients (40,3 %) the gastrectomy was performed by general surgeons and in 86 patients (59,7 %) it was performed by gastrointestinal surgeons. The average of nodes resected in the group A and B were 22,7 ± 9,9 and 32,6 ± 15 respectively (p=0,0001). A proper D2 Gastrectomy (more than 15 nodes) was performed in 77,6 % of the patients in group A, and 96,5% of the patients in group B.
Conclusion: The results of this study show that in patients with gastric cancer: (a) the number of resected nodes during a gastrectomy was higher in procedures performed by gastrointestinal surgeons, and (b) a proper nodal dissection for gastric cancer was performed more frequently by the same group. The findings suggest that in patients who underwent surgery for gastric cancer, the technical and academic skills play an important role and may improve survival.