J.Jpn. Surg. Soc.. 90(7): 965-971, 1989
Editorial
REFLECTION ON THE PROGRESS OF SURGICAL THOUGHT
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First Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan Noburu Sakakibara |
What was the basis of this development ? In this paper I take up surgery for gastric cancer as an example of the progress of surgical thought. The reason is gastric cancer has been the consecutive theme of the general meeting of The Japan Surgical Society.
The history of surgery for gastric cancer in Japan, which started from the report of two gastric resections by Prof. Tsugushige Kondo, means the history of the progress of surgery in Japan.
How did the pioneers of gastric surgery think? How did they resolve surgical problems? Furthermore, what kind of influence did they receive from the surgeons in the other fields ? How did they digest it and how did they link it to the progress of surgery? Conversely, what kind of influence did they give other fields ?
I discuss here the lymphadenectomy for surgery of gastric cancer as an example. The base of the so-called preventive lymphadenectomy derives from the systematic radical abdominal hysterectomy for cancer of the cervix uteri.
Since gastric cancer surgery started with the first gastric resection in 1897, it has been followed by lower esophagocardiectomy, total gastrectomy with jejunal interposition, combined resection of the common hepatic artery for thorough lymphadenectomy prior to Appleby, Nakayama's modification of Billroth-I and an extended radical operation.
As the result of these surgeon's efforts, gastric cancer surgery with rational lymphadenectomy is now established as we claimed.
I would like to reflect upon this history which was the progress of surgical thought. I think this reflection will be one of the valid clues to understand the present surgery and to consider future surgery.
At the present time, it will give us greater suggestions in considering the differences and unification of The Japan Surgical Society and this is the most important problem of The Society to be solved.
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