Rossi M, Dellagiacoma G, Dalle Ore G, Bovolato M, Pellini F, Cadamuro M, Moretto G, Santoro G
Istituto di Patologia Chirurgica, Università degli Studi, Verona.
Minerva Chir. 1998 Jan-Feb;53(1-2):9-14.
The choice of surgical technique in antral gastric cancer is still debated. Some authors support total gastrectomy in all cases. In recent years there is a trend to use total gastrectomy only if strictly necessary. Total gastrectomy allows a large lymph node excision, with better oncological results. The mortality rate and post-operative complications are quite similar today after gastric resection. Anyway, if exact histological diagnosis is possible and at least 6 cm unaffected tissue is preserved, oncological cure is possible by gastric resection.
Personal experience in 224 patients operated on from 1975 to 1994 is reported.
54.3% had antral gastric cancer, 16.5% body cancer and 8.7% fundus gastric cancer. Subtotal gastric resection should be the surgery of choice in antral gastric cancer. Early subtotal gastrectomy with R2, Advanced (III and IV-TNM) only resection with R2, and Advanced (II-TNM) total gastrectomy with R3.
胃窦癌手术技术的选择仍存在争议。一些作者支持对所有病例行全胃切除术。近年来，出现了仅在严格必要时才使用全胃切除术的趋势。全胃切除术可进行广泛的淋巴结清扫，肿瘤学效果更佳。如今，胃切除术后的死亡率和术后并发症相当相似。无论如何，如果能够做出准确的组织学诊断且保留至少6厘米未受影响的组织，通过胃切除术有可能实现肿瘤治愈。
报告了1975年至1994年期间对224例患者进行手术的个人经验。
54.3%为胃窦癌，16.5%为胃体癌，8.7%为胃底癌。胃窦癌应首选胃大部切除术。早期胃大部切除术行R2切除，进展期（Ⅲ和Ⅳ期 - TNM）仅行R2切除，进展期（Ⅱ期 - TNM）行全胃切除术并R3切除。
