[Early and late outcome of gastrectomy de principe]

Presented is a survey of 10 years experience of "Gastrectomie de principe" in the treatment of gastric cancer performed in the Surgical Department of Fulda. 219 gastrectomies were analysed, all of which were combined with lymphadenectomy of compartment I and II. Splenectomy was performed in 91%. 20% of the patients were operated with an early cancer, 37% showed no lymph node involvement. The rate of complications due to surgery was 13%, in 5.5% of patients we saw an insufficiency of the anastomosis, causing lethal outcome in 40% of these cases. The overall hospital mortality was 5.5%. Survival rates depended strongly on lymph-node involvement. The highest 5-year-survival of nearly 90% was seen in patients with an intestinal carcinoma in tumor stage T1 N0 M0, the 5-year-survival of all patients with an early cancer was 82%. The overall 5-year-survival was 25%. Total gastrectomy as the standard operative procedure shows low mortality, good controllability of complications and is to be recommended as a sufficiently safe therapeutical concept in patients with gastric cancer.