It has been definitly established that the choice of curative treatment for stomach carcinoma is
surgical resection, however, the types of operation which were performed have been discussed by
many authors.
Therefore, any improvement in the curates for stomach cancse is dependent upon the develope
ment of safe technics for extensive resection of primary lesion along with the areas of lymphatic
spread.
Author reviewed 100 cases of gastric carcinoma who had extensive gastrectomy in Gospel Hospital
during 9 years from January 1961 through October 1970. There were no difference in age and sex
incidence as compared with entire group of gastric carcinoma.
We had extensive gastrectomy because of direct invasion or extension to the mesocolon, colon,
pancreas, splenic hilum and regional lymphnodes matastasis. Postoperative complications were occured
in 23 cases of 100 patients who received extensive gastrectomy. The complication was wound
infection in 9 cases, anastomosis leakage in 3 cases, pleurisy in 5 cases, ascites in 5 cases and
paralytic ileus in 1 case.
Postoperative mortality was 1%. The operating type was showed in Table 4. It is considered
that regardless the location of stomach malignancy, regional metastasis is more important for
surgical extirpation e.g. Grime´s operation is recommended in case of suprapancreatic and splenic
lymphnodes involvement. In malignancy of lower part of the stomach which involved head of
pancreas, pyloric lymphnodes and paracolic lymphatic channel, subtotal gastrectomy with pancrea
ticoduodenectomy or subtotal gastrectomy with right hemicolectomy is the treatment of choice.
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