J.Jpn. Surg. Soc.. 55(7): 836-854, 1954

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宿題報告

Radical Operation for Carcinoma of the Stomach in Combination with the Resection of the Tail of the Pancreas

Surgeons of ten encounter with advanced carcinoma of the lower thoracic portion of the esophagus and the cardiac end or the body of the stomach for which radical operation has been considered to be impossible because their malignant infiltration has invaded the adjacent organs, or their lymphatic metastasis to the retroperitoneal lymph nodes have advanced intensely already. An attempt to remove the malignancy en masse, in combination with resecting the tail of the pancreas invaded and extirpating the spleen, has been done on 73 cases till now, in order to include such extended cases in the region of indication for radical operation. Is the tail of the pancreas resected at the point where the middle colic vessels cross to the under margin of the pancreas not only the malignant infiltration to it can be removed in almost all cases, but also the removal of the invaded retroperitoneal lymphnodes will be extremely simplified. This, therefore, should be prefered as a rational line for this purpose, and it was proved that the amount of the resected pancreas was from 2/5 to 3/5 of the whole.
The author mentioned and showd the operative procedure from practical point of view as well as the influence on the patients after this operation investigated through pancreas function, liver function and others. While the new knowledge concerning to methods of roentgen diagnosis, radioisotopic decision for indication and the others were reported.
Furthermore, the low operative mortality and the relatively successful follow-up results obtained have apparently revealed that this operative procedure is worthy to be recommended, and the of operation mortality rate of operation was 2.9 %.
(author's abstract)

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