[Results of the surgical therapy of stomach cancer]

1589 patients treated between 1965 and 1985 at the First Surgical Department of Vienna University were investigated to answer the following questions: 1. Development of postoperative mortality. 2. Is a palliative gastrectomy indicated? 3. Does gastrectomy en principe improve survival? 4. Quality of life after total gastrectomy. Postoperative mortality after distal resection was decreased from 8% to 1.2%. After total gastrectomy mortality was reduced from 20% to 4.3%. A significant factor in this improvement was the use of Y-Roux reconstruction as the only method during recent years. After palliative resections the mortality was not higher than in curative operations. Comparison of comparable tumour stages of the mid stomach revealed no benefit of gastrectomy over distal resection in terms of survival. This was found to apply to both cases of negative and positive lymph node involvement as well. Gastrectomy en principe does not seem to improve survival rates. The quality of life after total gastrectomy (Y-Roux) is satisfactory in most patients. Dumping and reflux were rare, diarrhoea occurred in 22%, anaemia in 30% of patients.