Kirchner R
Abteilung Allgemeine Chirurgie mit Poliklinik, Chirurgischen Universitätsklinik, Freiburg.
Zentralbl Chir. 1992;117(11):577-82.
Surgical strategy for gastric carcinoma consists of total gastrectomy as a rule combined with extended lymphadenectomy. For small tumors of the intestinal type located in the distal stomach distal gastric resection can be taken into consideration. In case of a high risk patient endoscopic polypectomy of a polypoid early gastric carcinoma can be sufficient. If the operation is done for cure intraoperative radiotherapy is employed within prospective trials in order to prevent local recurrence. Extended resections prolong survival time only if curativity will be achieved. For palliative situations procedures including removal of the tumor have better results with regard to quality of life and survival than bypass methods.
胃癌的手术策略通常包括全胃切除术,并通常结合扩大淋巴结清扫术。对于位于胃远端的小肠型小肿瘤,可考虑行远端胃切除术。对于高危患者,息肉样早期胃癌的内镜下息肉切除术可能就足够了。如果手术是为了根治,术中放疗将在前瞻性试验中应用,以预防局部复发。只有在实现根治性切除的情况下,扩大切除术才能延长生存时间。对于姑息性情况,包括切除肿瘤的手术在生活质量和生存方面比旁路手术有更好的效果。