title: [Surgical approach for upper gastric cancer].
abstract: OBJECTIVE
  To investigate the reasonable surgical approach for upper gastric cancer, surgical technique, and indications for combined resection of the spleen.
  
  
  METHODS
  Eight hundred and three patients with upper gastric cancer were operated in the Cancer Center of Sun Yat-Sen from December 1964 to December 2004, including 341 cases undergoing abdominal incision and 462 thoracotomy or abdomino-thoracic incision. Clinical data were analyzed retrospectively.
  
  
  RESULTS
  The operative time was significantly shorter in the abdominal incision group (170 vs. 220 min, P<0.01), as was the transfusion volume (200 vs. 650 ml, P<0.05). Positive resection margin was similar between the two groups (5.6% vs. 6.7%, P>0.05). There was no difference in overall postoperative complication rate (3.2% vs. 5.0%, P>0.05). Length of hospital stay was shorter in the abdominal incision group (21 vs. 26.6 days, P<0.05).
  
  
  CONCLUSIONS
  Selection of surgical approach should be based on the tumor characteristics. Abdominal incision should be the approach of choice where possible.
authors.affiliation: Department of Gastric and Pancreatic Surgery, Sun Yat-Sen University, Guangzhou 510060, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xiao-wei
authors.initials: XW
authors.lastname: Sun
authors.forename: You-qing
authors.initials: YQ
authors.lastname: Zhan
mesh_terms: D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D019616:Thoracic Surgical Procedures; D055815:Young Adult