[Stomach cancer: gastrectomy de principe]

Among surgical modalities of the gastric cancer total gastrectomy de principe and histology-oriented strategy are under discussion. In our own procedure we prefer total gastrectomy combined with extended lymph node dissection as the operation of choice justified by the results obtained. But caused by the lack of controlled studies these results cannot be used as an evidence. Nevertheless an exact analysis of the own material can show only an incidence of 5-30% in which total gastrectomy de principe may be a too extensive procedure in regard to the oncological point of view, but even these cases have to be examined in a randomised clinical study.