In order to identify the tendency of annual incidences of gastric cancer and the rate of total and extended total gastrectomy and to evaluate the preoperative diagnostic methods(UGI series, abdominal ultrasonography and CT) for determination of
resectability and to analyse the complications according to jejunal reconstructive types, authors analysed the patients who underwent total and extended total gastrectomy in Korea Cancer Center Hospital during the period from January, 1984 to
December,
1989.
During the period a series of 1,766 paients with gastric malignancy underwent surgery at Korea Cancer Center Hospital. Of these, total and extended total gastrectomy were performed in 144(8.2%) patients and complete follow-up was done in 123
cases(follow-up rate: 85.4%).
@ES The results were as follows:
@EN 1) The rates of total and extended total gastrectomy showed increasing tendency year by year.
2) Blood type A seemed to be risky group for gastric cancer(p<0.0001).
3) The overall accuracy of UGI, abdominal CT and USG for determination of preoperative resectability were 63.8%, 58.9% and 39.5%, respectively.
4) The incidences of postoperative reflux esophagitis were 13.3%, 18.2% and 24.4% according to fundic tubojejunostomy(PAIK' s procedure) with Braun anastomosis, Roux en Y esophagojejunostomy and loop esophagojejunostomy with Braun anastomosis,
respectively.
5) The incidences of dumping syndrome were 6.7%, 13.6% and 7.0% according to fundic tubojejunostomy with Braun anastomosis, Roux en Y esophagojejunostomy and loop esophagojejunostomy with Braun anastomosis respectively.
6) Postoperative complication rate was 9.0%(13/123). Lung problem was the most common complication. Operation mortality was 2.4%(3/123).
7) Five year survival rates were 87.5%, 77.7%, 43.8% and 8.8% according to stage I, II, III and IV, respectively.
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