Gastrectomy for Cancer

  • Jameson L. Chassin


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.



Total Gastrectomy Gastric Pouch Lymphatic Metastasis Proximal Stomach Left Gastric Artery 
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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

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