This study is a clinical analysis of 289 patients with gastric cancer treated with total gastrectomy at Department of Surgery, Pusan Gospel Hospital, Kosin Medical college during the period of 10 years from January 1980 to December 1989.
@ES The results were as follows:
@EN 1) During 10 years, operation was performed in 2209 patients with gastric cancer, and among them 289 cases913.1%) were total gastrectomy.
2) Pathologic finding of gastric cancer revealed that adenocarcinoma was 281 cases (97.2%), malignant lymphoma was 5 cases (1.7%) and others were 3 cases(1.1%).
3) The most frequent age group was 6th decade (37.7%) and male to female ratio was 2 :1 .
4) Tumors were located at cardia & fundus in 95 cases(33.8%), body in 111 cases(39.5%), antrum in 31 cases(11.0%) and entire wall as linitis plastica in 44 cases(15.7%).
5) Of 281 cases of adenocarcinoma, curative resection was done in 168 cases959.8%) and palliative resection was 113 cases940.2%).
6) Total gastrectomy without other organ resection was done in 117 cases (40.5%), total gastrectomy combined with splenectomy and partial pancreatectomy in 89 cases(30.8%), total gastrectomy combined with splenectomy in 34 cases911.8%), and
other
combinations of resection were done in 49 cases 916.9%).
7) Several methods of alimentary tract reconstruction were used as follows: end to side esophagojejunostomy with Braun anastomosis in 119 cases(41.2%), Roux-en-Y esophagojejunostomy in 110 cases(38.0%), Hunt-Lawrence's pouch in 34 cases(11.8%),
double
circuit esophagojejunoduodenal plasty(EDDP) in 13 cases(4.5%), and Longmire-Henley's jejunal loop interposition in 13 cases(4.5).
8) Major postoperative complications occurred in 101 patients(34.9%); pulmonary complications in 40 cases, wound complications in 22 cases and anastomotic leakage in 22 cases.
9) Operative mortality was 1.7%(5/289). Causes of death were leakage of anastomotic site in 2 cases, circulatory-respiratory failure in 2 cases and intraabdominal bleeding in 1 case.
10) Of 289 cases, follow up of survival was done in 284 cases(98.3%). Survival rate I curatively resected group was as follows: 1 YSR(Year Survival Rate) 80.3%, 2 YSR 63.7%, 3 YSR 54.6%, 4 YSR 45.4% and 5 YSR 36.3%.
11) In curatively resected group, 5 YSR related to stage was 83.9% in stage I, 64.3% in stage II, 23.1% in stage III and 0% in stage IV.
12) In curatively resected group, survival rate related to lymph node metastasis was as follows: 1 YSR was 90.3% 3 YSR was 74.1% and 5 YSR was 66.7% in no metastatic group, and 1 YSR was 74.1%, 3 YSR was 40.4% and 5 YSR was 17.7% in metastatic
group.
13) In curatively resected group, 5 YSR related to the extent of resection was 50.8% in cases performed total gastrectomy without other organ resection and 26.6% in case performed total gastrectomy combined with other organ resection.
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