Advertisement

Gastrectomy for Cancer

  • Jameson L. Chassin
Chapter
  • 252 Downloads

Abstract

For the past 30 years there has been great confusion over the choice of operations for gastric malignancies. The pendulum has swung from partial gastrectomy to total gastrectomy and back again. Lacking adequate data that correlates survival statistics with various lesions, surgeons have based their choice of operations on anatomical study of the distribution of lymphatic metastases. The routine use of total gastrectomy for all gastric malignancies has been shown not to improve survival of patients. Several major controversies still remain:
  1. 1)

    Proximal gastric lesions are treated by total gastrectomy by some surgeons and by resection of the lower esophagus and proximal stomach by others (see Chaps. 6 and 8).

     
  2. 2)

    According to Hoerr and to Nyhus, antral malignancy requires only a distal two-thirds gastrectomy, including adjacent lymph nodes, duodenum, and omentectomy. On the other hand, Menguy recommends an 80%–90% gastrectomy, with division of the left gastric artery at its origin, omentectomy, and splenectomy, followed by gastroduodenostomy or gastrojejunostomy.

     

Keywords

Total Gastrectomy Gastric Pouch Lymphatic Metastasis Proximal Stomach Left Gastric Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cady B et al. (1977) Gastric cancer, con-temporary aspects. Am J Surg 133: 423PubMedCrossRefGoogle Scholar
  2. Chassin JL (1978) Esophagogastrectomy: data favoring end-to-side anastomosis. Ann Surg 188: 22PubMedCrossRefGoogle Scholar
  3. Hoerr S (1973) Prognosis for carcinoma of the stomach. Surg Gynecol Obstet 137: 205PubMedGoogle Scholar
  4. Menguy R (1974) Surgical treatment of gastric adenocarcinoma. JAMA 228: 1286PubMedCrossRefGoogle Scholar
  5. Nyhus LM, Wastell C (1977) Surgery of the stomach and duodenum, Little, Brown, Boston, p. 672Google Scholar
  6. Paulino F, Roselli A (1973) Carcinoma of the stomach. Curr Probl SurgGoogle Scholar
  7. Soga J et al. (1979) The role of lymph- adenectomy in curvative surgery for gastric cancer. World J Surg 3: 701PubMedCrossRefGoogle Scholar
  8. Spencer FC (1956) Ischemic necrosis of the remaining stomach following subtotal gastrectomy. Arch Surg 73: 844Google Scholar
  9. Thompson, NW (1963) Ischemic necrosis of proximal gastric remnant following subtotal gastrectomy. Surgery 54: 434PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1980

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.School of MedicineNew York UniversityUSA
  2. 2.University Hospital, New York University Medical CenterUSA
  3. 3.New York Veterans Administration HospitalUSA
  4. 4.Bellevue HospitalUSA
  5. 5.Long Island Jewish-Hillside Medical CenterUSA

Personalised recommendations