Longmire W P
MMW Munch Med Wochenschr. 1977 May 6;119(18):613-6.
In our western countries gastric cancer is no longer a local disease when first diagnosed in more than 55% of patients. Fairly extensive experience with extended radical procedures has failed to demonstrate any significant improvement in the 5-year survival rate. Moreover, increased operative morbidity and mortality have even aggravated our results. Subtotal gastrectomy (Billroth II) is therefore recommended for the carcinoma of the antrum, total gastrectomy (with interposition of jejunum) for carcinoma of the cardia and selected cases. Our current goal should be greater efforts towards early diagnosis to reach the results of Japanese surgeons with "early superficial cancer" of the stomach.
在我们西方国家，超过55%的胃癌患者在首次诊断时就不再是局部疾病。广泛开展扩大根治术的丰富经验未能显示出5年生存率有任何显著提高。此外，手术发病率和死亡率的增加甚至使我们的治疗结果更糟。因此，对于胃窦癌推荐行胃大部切除术（毕Ⅱ式），对于贲门癌及部分病例推荐行全胃切除术（空肠间置）。我们当前的目标应该是加大早期诊断的力度，以达到日本外科医生对胃“早期浅表癌”的治疗效果。
