Total gastrectomy for gastric cancer. Clinical considerations on 431 cases

✍ Scribed by Masao Fujimaki; Jun Soga; Kanji Wada; Hisashi Tani; Osamu Aizawa; Masaki Kawaguchi; Kiyoshi Ishibashi; Masakatsu Maeda; Tomoyuki Kanai; Yukio Omori; Terukazu Muto

• Publisher: John Wiley and Sons
• Year: 1972
• Tongue: English
• Weight: 370 KB
• Volume: 30
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(197209)30:3<660::aid-cncr2820300313>3.0.co;2-4

✦ Synopsis

O n the basis of the invasive and metastatic natures of gastric cancer, 431 cases of total gastrectomy were analyzed from the standpoint of surgical treatments. Histologic scrutinization showed that 83% of the cases (199/241) had lymph node metastasis, and 26% of the lymph nodes (2,226/8,698) were involved. I n cancer of the upper stomach, lymph node involvement became suddenly widespread in extent and high in rate. both for the cases and for the lymph nodes with the serosal invasion by the primary lesions. I n addition, a serial sectioning technique from the splenic hilus through the splenic artery region disclosed that latent lymph node metastasis evident only on histologic scrutinization consisted of 62% of the involved lymph nodes. These rather unexpected results suggest that, in most cases with advanced cancer in the upper stomach or of a diffuse form, a total gastrectomy combined with a splenectomy and caudal hemipanaeatectomy would be a necessary surgical procedure.