J.Jpn. Surg. Soc.. 87(9): 1205-1208, 1986
Report on the annual meeting
SURGICAL TREATMENT OF CARCINOMA OF THE STOMACH INVADING TO ESOPHAGO-GASTRIC JUNCTION
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Department of Surgery, Niigata Univ., School of Med., Nigata, Japan Koichi Sasaki, Terukazu Muto |
The purpose of this study is to elucidate clinicopathological features of these and to discuss the rational surgical treatment of patients with gastric carcinoma invading to esophago-gastric junction.
One-hundred and thirty (7.4%) of 1,767 cases who under-went a gastrectomy for carcinoma of the stomach during the 25-year period between 1957 to 1985 were selected for this investigation.
Of these patients, a total gastrectomy with lower esophagectomy on 93 (71.5%) and caudal hemipancreatectomy with splenectomy on 116 (89.2%) were carried out.
Over all metastatic rate of lymph node was 80% (104/130) and that of lower mediastinal one was 22.9% (30/130).
The 5-year survival rate of the patient after curative resection was 45.8%.
It is severely impossible to eradicate a primary lesion with an adequate proximal margin of the esophagus and lymph node located in the lower mediastinum by only abdominal procedure. On the basis of our experience it is emphasized that a laparotomy combined with median sternotomy is an ideal approach, especially, esophagectomy without thoracotomy or right thoracotomy may be added if indicated.
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