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[Gastric cancer. Which resection?]
M Rossi1, G Dellagiacoma, G Dalle Ore
1Istituto di Patologia Chirurgica, Università degli Studi, Verona.
Background:
The choice of surgical technique in antral gastric cancer is still debated. Some authors support total gastrectomy in all cases. In recent years there is a trend to use total gastrectomy only if strictly necessary. Total gastrectomy allows a large lymph node excision, with better oncological results. The mortality rate and post-operative complications are quite similar today after gastric resection. Anyway, if exact histological diagnosis is possible and at least 6 cm unaffected tissue is preserved, oncological cure is possible by gastric resection.
Methods:
Personal experience in 224 patients operated on from 1975 to 1994 is reported.
Results And Conclusions:
54.3% had antral gastric cancer, 16.5% body cancer and 8.7% fundus gastric cancer. Subtotal gastric resection should be the surgery of choice in antral gastric cancer. Early subtotal gastrectomy with R2, Advanced (III and IV-TNM) only resection with R2, and Advanced (II-TNM) total gastrectomy with R3.