Chronological Changes in Surgical Treatments for Gastric Cancer with Special Reference to Lymph Node Dissection

Keizo Sugimachi

The Second Department of Surgery, Faculty of Medicine, Kyushu University

In the last 2 decades, there has been a striking improvement in Japan in the prognosis of gastric cancer. Much of the improvement is attributed to the increased early detection of the cancer and the standardization of prophylactic lymphadenectomy. However there are limitations to surgery. Here, an effective combined therapy has to be considered. Since the 1980s, the clinical values of prophylactic splenectomy in total gastrectomy has remained an open question. Limited operation for early gastric cancer and extensive en bloc resection for advanced cancer are recently advocated treatments. Although such approaches warrant further attention, it must be stressed that radicality, safety of surgery and the alleviation of symptoms for such patients play a critical part in determining the treatment of choice.

Key words
gastric cancer, lymph node dissection, prognosis

Reprint requests
Keizo Sugimachi The Second Department of Surgery, Faculty of Medicine, Kyushu University
3-1-1, Maidashi, Higashiku, Fukuoka, 812 JAPAN

Accepted
October 11, 1990

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