Meyer H J, Jähne J, Wilke H, Pichlmayr R
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover, Germany.
Semin Surg Oncol. 1991 Nov-Dec;7(6):356-64. doi: 10.1002/ssu.2980070607.
Total gastrectomy is discussed as the operation of choice among different surgical approaches for gastric carcinoma. We prefer the performance of an elective total gastrectomy with systematic lymphadenectomy (compartments I and II) and obligatory splenectomy. A retrospective study of 1,704 consecutive cases of gastric carcinomas showed a better outcome following total gastrectomy in relationship to distal subtotal gastrectomy, but these results cannot be used as evidence because of the lack of a prospective study. Nevertheless, a precise analysis of our cases in regard to tumor site and tumor type could show a frequency of only 6% to maximally 30%, in which elective total gastrectomy may represent a procedure too extensive to justify for an oncological course.
在胃癌不同手术方式中，全胃切除术被视为首选手术。我们更倾向于进行择期全胃切除术，并系统性清扫淋巴结（Ⅰ区和Ⅱ区）且必须切除脾脏。一项对1704例连续胃癌病例的回顾性研究显示，与远端次全胃切除术相比，全胃切除术后的预后更好，但由于缺乏前瞻性研究，这些结果不能作为证据。然而，对我们病例的肿瘤部位和肿瘤类型进行精确分析后发现，择期全胃切除术可能过于广泛，仅6%至最多30%的病例从肿瘤学进程来看有实施该手术的必要。
