Harder F, Dürig M, Laffer U, Neff U
Department Chirurgie der Universität, Kantonsspital, Basel.
Langenbecks Arch Chir. 1987;372:583-6. doi: 10.1007/BF01297886.
The controversy about the extent of resection of gastric cancer has been lasting for decennies. The extreme viewpoints may have become less divergent recently although controlled data are still lacking. As gastrectomy has generally become safer, a somewhat broader indication for it is justified. Subtotal resection is still justified for cancer of the antrum of the intestinal type (Laurén-classification) without evidently involved distant nodes and as long as a clear margin can be expected, furthermore in some advanced disease situations and finally in high risk patients, especially with severe cardiopulmonary handicaps.
关于胃癌切除范围的争论已经持续了数十年。尽管目前仍缺乏对照数据，但极端观点之间的分歧最近可能已有所减少。由于胃切除术总体上已变得更加安全，因此有理由稍微扩大其适应证。对于肠型（劳伦分类）胃窦癌，只要没有明显的远处淋巴结受累且有望获得切缘阴性，行次全切除仍然是合理的；此外，在一些晚期疾病情况下以及最终在高危患者中，尤其是伴有严重心肺功能障碍的患者中，次全切除也是合理的。
