Modified Schoemacher resection for distal gastric cancer.
Between October 1979 and February 1987, 30 consecutive patients with cancer of the lower stomach underwent B1-Schoemacher resection with a tubular gastric pouch. Operative mortality was 0% and operative morbidity 10% (leak 3%, anastomotic stricture 3% and abscess 3%). After a mean follow-up of 30 months, the expected 5-year survival was 32%. The causes of death were: 7 distant relapses, 2 noncancer diseases and 1 new primary cancer. The overall incidence of postgastrectomy symptoms was 23% for the whole series and 35% for the patients harboring small tumors. Mild dyspepsia occurred in 71%. The declining concept of total gastrectomy as an essential requirement for curative resection and the recent evidence that B2 for gastric lesions is a carcinogenic operation necessitate alternative procedures. The data show that modified Schoemacher resection can be consider a valid challenge to B2.
Valente
M
M
Division of Surgical Thoracic Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori di Milano.
Alloisio
M
M
Pastorino
U
U
Tavecchio
L
L
Cataldo
I
I
Bedini
A V
AV
Muscolino
G
G
Ongari
M
M
Ravasi
G
G
D000368:Aged; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D013274:Stomach Neoplasms / Q000601:surgery*