J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 5692KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 53(2): 98-107, 1952

Original article

STUDIES ON THE RECURRENCE OF CARCINOMA OF THE STOMACH AFTER GASTRECTOMY

I Surgicl Department, Tokyo University Medical School (Director, Prof. Kentaro SHIMIZU)

Hiromichi ISHIHARA

Resected specimens of the stomach were histologically studied in 16 cases of recurrence and 15 cases of more than 8 years survivors after gastrectomy for carcinoma of the stomach. And in cases of the recurrence their states were examined by relaparotomy, or by autopsy.
1. The distances between the tumor and both stumps were measured under histological examination. In the group of recurrence 3 cases showed invasion into duodenal stump and same number of cases into the oral stump, and 6 cases in both stumps. In all of these cases, the recurrence was observed at the site of invasion. In the group of survivors no invasion was seen in the stumps.
2. All lymphnodes in the specimens were examined. In the group of recurrence, only 2 cases showed no invasion and one case had only one invaded node. The others had many invaded ones and it is quite probable that some invaded nodes were left when the stomach was resected. The invasion-rate of the lymphnodes was highest in the inferior and superior pyloric region. And the recurrence of carcinoma in the lymphnode was found in all of the cases which showed invaded lymphnodes, the most frequently around the duodenal stump. In the group of survivors one lumphnode was seen invaded in only one specimen.
3. Serosal invasion of the stomach was studied at the centre of the tumor. In the group of recurrence 10 cases had the serosal invasion, in 7 of which the peritoneal recurrerice took place. Even in the group of survivors 3 cases showed the serosal invasion.
4. Therefore, at the radical operation of the gastric cancer, the resection of the stomach should be done under microscopical guidance during the operation, and the lymphnodes should be cleared with greatest care especially in the pyloric region. And considering the recurrence, the method Bilroth II. is preferable to Billroth I.
5. The prognosis after the radical operation of the gastric cancer can with much probability be determined be careful histological examination of the resected specimen.
(author's abstract)

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