Surgical treatment of advanced gastric cancer

By | April 10, 2012

So far the treatment of gastric cancer, the effect is still not satisfactory. Reasons in this regard is not clear because the incidence of gastric cancer can not be prevented in the pathogenesis of the former; the other is already in the time of diagnosis in most cases, patients with advanced, effective natural poor. Early diagnosis remains the key to improve cancer treatment.
1. The standard radical mastectomy: surgical treatment of gastric cancer is a local treatment, the so-called radical surgery is to include the tumor tissue , possible tumor invasion of surrounding normal tissue organization and complete resection. Radical gastrectomy general scope should include the primary lesion proximal or distal stomach, including the 2 / 3 3 / 4, all sizes omentum, liver and stomach, and the gastrocolic ligament and mesocolon anterior lobe, The first part of the duodenum and stomach regional lymph nodes. For gastric cancer, the lymph node metastasis is an important means of transfer, so the lymph node dissection is an important part of gastric cancer surgery.
However, there is a dispute the scope of lymph node dissection, lymph node metastasis were divided into the first leg, second leg and third leg, in accordance with the order, the general view that the scope of cleaning may be transferred to exceed the range of lymph nodes, such as the possible first stop lymph node to lymph node dissection is required to the second station. Now generally believed that the expansion of the lymph node dissection was not significantly improve patient survival, and may decrease the incidence of complications due to survival.
2. Pylorus-preserving resection of gastric cancer: pylorus preserving stomach resection meet the physiological function of digestion, can improve quality of life. However, pylorus-preserving is to make the parts are extremely limited lymph node dissection, so the difficulty of surgery significantly increased. Pylorus preserving radical gastrectomy with standard radical gastrectomy compared to the operation time, blood loss, no significant difference. Pylorus-preserving resection of gastric tube removal in patients with late delays may occur and increase consumption of hospital stay. Distal gastrectomy with traditional long-term results compared to the gastric pylorus-preserving radical surgery to reduce the dumping syndrome, to maintain nutritional status, to keep the stomach and gallbladder emptying function has certain advantages.
Surgical treatment of advanced gastric cancer, therefore, should adopt a positive attitude cancer resection, not easily to be radical in some cases to make a simple palliative resection, some patients are deprived of the chance of cure.

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