D2 distal subtotal gastrectomy for antral carcinoma

A 53-year-old Chinese man was pre-operatively diagnosed with adenocarcinoma of gastric antrum (moderately differentiated). The tumor was preoperatively assigned to T2-3N1-2M0. Preoperative evaluation of the patient allowed him to undergo surgical treatment. In advanced gastric cancer, D2 lymphadenectomy was needed. Therefore, distal subtotal gastrectomy with D2 lymphadenectomy was adopted. During surgical exploration, abdominal or pelvic metastasis was not found and local invasion was not observed. The distal gastrectomy with Billroth I reconstruction was performed, two thirds of the stomach was resected. Lymph nodes of group 1, 3, 4, 5, 6, 7, 8, 9, 11P, and 12 were dissected. The whole operation lasted about 3 hours and intraoperative blood loss was about 100 ml. The patient recovered well after the surgery.