Comparing the short‐term outcomes of laparoscopic distal gastrectomy with D 1+ and D 2 lymph node dissection for gastric cancer

Laparoscopic distal gastrectomy ( LDG ) with D 1+ lymph node dissection ( LND ) for early gastric cancer has been widely accepted. However, LDG with D 2 LND for advanced gastric cancer remains in limited use. The aim of this retrospective study was to clarify the safety of LDG with D 2 LND for gastric cancer. Methods From J anuary 2010 to S eptember 2014, 296 patients underwent LDG ; those who received D 1+ LND ( n  = 230) or D 2 LND ( n  = 66) were included in this study. The clinicopathological characteristics and short‐term outcomes of both groups were investigated and compared. Results There were no significant differences in the incidence of postoperative complications between the two groups. However, the frequency of infectious intra‐abdominal complications was higher in the D 2 LND group than in the D 1+ LND group. Additionally, a lower risk of infectious intra‐abdominal complications was seen with certified than with uncertified operators. Conclusion The evaluation of short‐term outcomes demonstrated that LDG with D 2 LND is generally feasible. However, the risk of infectious intra‐abdominal complications is higher with D 2 LND than with D 1+ LND . Also, D 2 LND should be performed by trained operators.