[The value and limits of subtotal gastrectomy in gastric cancer]

In the interval 1970-1988, in 321 of 670 patients with gastric neoplasm admitted to the 1st Surgical Clinic of Iaşi a subtotal gastrectomy was performed. Most patients were males (68.9%), more commonly aged between 50 and 70 years and in advanced evolutive stages. The gastric neoplasm were sited in order of frequency in the antrum (46.9%), body of the stomach (34.6%), eso-cardio-tuberosity (11.5%), linitis (4%), gastric stump and malignant ulcer (3%). Surgery was possible in only 59% of the cases (25% curative and 34.1% palliative). The surgical technique and its difficulties are detailed. In the 321 subtotal gastric resections 20 complications, 4 deaths (1.2%) and 20% survivals over 5 years were recorded. It is concluded that radioendoscopic and microscopic investigations, with their possibility of an early diagnosis, may cause a limitation of the indications of total gastric resection in the treatment of gastric neoplasm in favour a subtotal resection, more satisfactory from the functional viewpoint.