J.Jpn. Surg. Soc.. 82(9): 940-943, 1981
Report on the annual meeting
FUNDAMENTAL RULES OF RADICAL OPERATION FOR DIGESTIVE TRACT CANCER
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Cancer Institute Hospital, Tokyo Tamaki Kajitani |
Surgical approach should be selected, considering the clear recognition of cancer, the degree of curability and security of operation. Of course, curability is the most important. If we make an error in selecting the approaching route, it will result in the operation with low curability.
In removing the primary lesion, partial or total resection of the primary organ or combined resection of adjacent organs is applied. Considering not only the macroscopical extension but also biological characteristics of each cancer, sufficient resection should be performed.
The extent of lymph node dissection should be carefully determined according to the degree of metastasis, but systematic prophylactic dissection is a fundamental urle, as far as macroscopic al evaluation of metastasis is obscure. Sometimes, preponderant dissection under histological control is also enevitable. The dissection should be performed en bloc as much as possible. Therefore, combined resection of the pancreas and spleen is often performed in gastric cancer.
As a rule, radical operation is performed in one stage, but division of operation is sometimes enevitable for avoiding severe complication, The dividing operation, in which cancer tissue may be left partly during the period between the first and the second operations, has some drawbacks in curability. We applied the dividing operation, in which cancer is removed completely at the first operation and the reconstuction is performed at the second operation, in case of esophageal cancer and colon cancer combined with ileus.
Finally, we described concretely the fundamental rules of radical operation in each cancer of the stomach, esophagus and rectum.
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