GASTRIC-CARCINOMA - IS RADICAL GASTRECTOMY WORTH WHILE

  • 1 January 1980
    • journal article
    • research article
    • Vol. 62  (1) , 25-30
Abstract
Total gastrectomy as the treatment of choice [human] gastric carcinoma was evaluated during 1945-1955. The operative mortality was higher, the 5-yr survival rate was lower and the undesirable digestive side effects were greater than those following subtotal resection. The very radical subtotal resections with miniature gastric remnants resulted in postgastrectomy symptoms quite similar to those of total gastrectomy. Technical refinements of esophagojejunal anastomoses and the use of nutritional supplements and antianemic therapy reduced but did not eliminate the sequelae of radical gastrectomy. A review of 15 reports of gastric cancer treatment from 8 countries suggests that in recent years total gastrectomy has been utilized in 25.4% of resections, with an average operative mortality of 21.7% and a 5-yr survival of 12.3%. Radical resection or total gastrectomy is recommended for certain specific conditions, but for the usual antral gastric cancer subtotal resection distal to the vasa brevia with preservation of the gastric fundus and spleen is recommended.