Reasonable Excision Range for Upper Third and Middle Third Gastric Cancer Less than 4 cm in Size

Keiichiro Ohta, Mitsumasa Nishi, Shigekazu Ohyama, Takashi Takahashi, Toshifusa Nakajima

Division of Gastroenterological Surgery, Cancer Institute Hospital

Appropriate indications for proximal gastrectomy in cases with cancer in the upper third of the stomach and pylorus preserving gastrectomy (PPG) for those with middle third gastric cancer, i.e. without compromising curability, were examined. Study materials included 341 upper third and 1258 middle third gastric cancers less than 4 cm in size which were surgically resected at our hospital between 1946 and 1994. Localized, superficial lesions less than 30 mm in size, and other macroscopic types including differentiated and undifferentiated lesions with neither lymph node metastasis nor serosal involvement are indications for proximal gastrectomy provided that the lesion is less than 4 cm in size and is an upper third gastric cancer. Polypoid, protruded, ulcerated and depressed types, less than 20 mm in size, and differentiated types less than 18 mm in size or undifferentiated types without serosal involvement, are indications for PPG if the lesion is less than 4 cm in size and is a middle third gastric cancer.

Key words
proximal gastrectomy, pylorus preserving gastrectomy, limited operation for upper third, middle third gastric cancer

Reprint requests
Keiichiro Ohta Department of Surgery, Cancer Institute Hospital
1-37-1 Kami-ikebukuro, Toshima-ku, Tokyo, 170 JAPAN

Accepted
July 2, 1997

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