| Abstrakt: |
Results of surgical treatment of 170 patients with early cancer of the stomach are analyzed. There were 113 patients with tumor invasion within the bounds of the mucous membrane (m -- 113), the others had invasion within the bounds of the submucous membrane (sm -- 57 patients). Impressed and ulcered macroscopic types of early cancer (IIc + III) were diagnosed most often: 57% m+sm (97 of 170), 58.4% m+sm (97 of 170), 54.4% sm (31 of 57), respectively. Poorly differentiated tumors prevailed over moderate- and well-differentiated tumors - 68.8% (117 of 170) and 31.2 (53 of 170) patients, respectively. Subtotal distal resection of the stomach has been performed in 118 (69,4%) patients, subtotal proximal resection -- in 13 (7.7%), gastrectomy -- in 22 (12.9%), resection of 2/3 stomach -- in 14 (8.2%), resection of the cardia - in 3 (1,8%). Lymphadenectomy has been performed in 156 patients including 1 (0.6%) patient with D0-lymphadenectomy, 88 (56.4%) - D1, 62 (39.7%) -- D2, and 5 (3.2%) -- D3. Metastases to the regional lymph nodes have been revealed in 8 (5%) cases -- 2 m and 6 sm. Extended lymphodissections (D2 and D3) have improved significantly long-term results. Five-year survival among the patients who had undergone extended operations with D2 and D3 lymphadenectomies was higher compared with patients after limited and standard operations (D0 and D1) -- 96.0+/-2.5 and 87.0+/-3.5%, respectively. |
