[Extensive lymphadenectomy in operations for stomach cancer]

Serial histological assays of lymph nodes removed during extensive lymphadenectomy not infrequently reveal metastases, in case of gastric cancer, in paraaortic lymph nodes and the nodes located along the celiac trunk, splenic and hepatic vessels. Among 35 patients 19 showed metastases in these nodes. Metastases were detected also in cases when lymphnodes of these collectors seem to be intact (in8 of 23 patients). Routine lyphadenectomy is unlikely to be considered radical. A total of 112 operations with extensive lymphadenectomy have been performed: gastrectomy (84), distal resection (12), proximal resection (13), extirpation of the gastric stump (3). Of special value is transabdominal approach associated with instrumental correction by dilators attached to an operating table (the technic suggested by M. Z. Sigal). The technic of this operation is described. A total mortality rate was 14.3%. There were no lethal complications due to lymphadenectomy. It seems rational to revise the currently used estimates of the degree of radicality of lymphadenectomy in gastric cancer.