Radikalit�t und pathophysiologische Gesichtspunkte bei der Resektion des Magencarcinoms

Schreiber, Hans

doi:10.1007/bf01440527

Cited by 17 publications

(3 citation statements)

References 18 publications

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“…2. The total gastrectomy had to be indicated as necessary ("gastrectomie de necessit6") [6,7] if the tumor was so advanced that a subtotal gastrectomy was not radical enough. The operation concept was the total gastrectomy together with the systematic lymphadenectomy according to Japanese rules [13,14] (Fig.…”

Section: Selection Of Patients and Perioperative Managementmentioning

confidence: 99%

“…This state of affairs was realized by some surgical researchers [5][6][7][8] who detected and described (in addition to postoperative survival) functional defects after total gas.trectomy such as lack of appetite and hunger, and reduced food intake, followed by loss of body weight. Several methods were described to reanastomose or to reconstruct the digestive tract after total gastrectomy [5, 6, %11] (for a review, see "Surgical Procedures for Gastric Substitution" by Herfarth el al., p. 689).…”

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Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

et al. 1987

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This is an interim report of a randomized clinical trial on esophagojejunostomy (E J) versusHunt-Lawrence-Rodino (HLR) pouch as reconstruction techniques following total gastrectomy and systematic lymphadenectomy for gastric cancer treatment. The randomized trial preceded a pilot study comparing the Longmire-Gutgemann interposition ant/ the HLR. The pilot study included 7 patients, the randomized trial 38 patients (60 planned). The main outcome variables in the pilot study were food resorption, caloric intake, and body weight. Survival probability and general well-being (quality of life) were measured in the randomized trial. A score was composed of diseasespecific and socio-personal variables with well-being ranging from 0 (worst) to 14 (best) points.Concerning food resorption in the pilot study, no relevant advantage of the duodenal passage was found. The main postoperative disorder was insufficient food intake. Despite a radical operation, a hospital mortality rate of 16%, and a complication rate of 37%, gastric cancer still has a poor prognosis. In the randomized trial only 15 (39%) of 38 patients were alive 1 year after operation, but the survival probability was higher (58%) after HLR than after EJ (24%) (p < 0.05). Hunger and appetite were strongly reduced during the first 6 months after operation. Food intake was less than half of the preoperative values, which was reflected by an average decrease in body weight of 7 kg.Patients dying within the first year after total gastrectomy suffered an irreversible loss of quality of life (scoring 7 points). They had no objective benefit from the operation. Patients surviving this period regained quality of life and exceeded preoperative values, especially after HLR.We conclude that HLR-operated patients who have a chance of surviving for at least 1 year benefit from total gastrectomy in regard to quality of life.

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Section: Selection Of Patients and Perioperative Managementmentioning

confidence: 99%

mentioning

confidence: 99%

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

et al. 1987

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“…Ausreichende chirurgische Radikalit~it steht als therapeutische Grundvoraussetzung beim Magencarcinom weiterhin im Vordergrund [24]. Dieses Ziel wird sowohl durch die Gastrektomie als Regel-oder Standardoperation -so die wohl zutreffendere Definition der Gastrektomie de principe -als auch durch das sog.…”

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100. Magencarcinom: Gastrektomie de principe

Meyer

Jähne

Pichlmayr

1987

Langenbecks Arch Chiv

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Among surgical modalities of the gastric cancer total gastrectomy de principe and histology-oriented strategy are under discussion. In our own procedure we prefer total gastrectomy combined with extended lymph node dissection as the operation of choice justified by the results obtained. But caused by the lack of controlled studies these results cannot be used as an evidence. Nevertheless an exact analysis of the own material can show only an incidence of 5-30% in which total gastrectomy de principe may be a too extensive procedure in regard to the oncological point of view, but even these cases have to be examined in a randomised clinical study.

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Magen

Wänke¹

1971

Spezielle Pathologische Anatomie

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Radikalit�t und pathophysiologische Gesichtspunkte bei der Resektion des Magencarcinoms

Cited by 17 publications

References 18 publications

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

Pouch versus esophagojejunostomy after total gastrectomy: A randomized clinical trial

100. Magencarcinom: Gastrektomie de principe

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