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Total gastrectomy for early gastric cancer
Author(s) -
Kitamura Kazuya,
Yamaguchi Toshiharu,
Okamoto Kazuma,
Taniguchi Hiroki,
Hagiwara Akeo,
Sawai Kiyoshi,
Takahashi Toshio
Publication year - 1995
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930600204
Subject(s) - medicine , gastrectomy , lymph node , cancer , stomach , surgery , dissection (medical) , anastomosis , fistula , reflux esophagitis , gastroenterology , pancreatic fistula , general surgery , reflux , pancreas , disease
A total gastrectomy was performed in 49 patients with early gastric cancer, and the effectiveness of this procedure was evaluated by reviewing the hospital files of the patients. The reasons for this total gastrectomy were as follows: (1) lymph node dissection for 22 patients, (2) surgeon's choice in reconstruction for 10 patients, (3) modification of the surgery from subtotal to total gastrectomy for seven patients, (4) synchronous multiple cancers for seven patients, and (5) cancer in a stomach remnant for three patients. Of 49 patients, 42 had the cancerous lesions in the upper portion of their stomachs. Lymph node involvement occurred in 5 patients, but not in the supra‐ or infrapyloric lymph nodes. Postoperative complications such as anastomotic leakage, reflux esophagitis and pancreatic fistula occurred in five, four, and two patients, respectively. Postoperative death, including two patients who died within 30 days after the surgery, occurred in 5 patients. Our study showed that total gastrectomy resulted in excessive unnecessary surgery in 39 out of 49 patients (79.6%). We conclude that a total gastrectomy should not be performed on patients with early gastric cancer except for synchronous multiple cancers and for cancers in a stomach remnant. © 1995 Wiley‐Liss, Inc.