Abstract
Gastric resection offers the highest rate of long-term survival for patients with localized gastric cancer and should be the ultimate goal in patients that are appropriate candidates for surgery. Chemotherapy and chemoradiation therapy are important adjunct treatment modalities: Patients who receive adjuvant or perioperative therapy demonstrate higher overall survival rates compared with patients who undergo only surgery. The National Comprehensive Cancer Network guidelines recommend an extensive preoperative evaluation for patients with gastric cancer, including endoscopic ultrasonography, computed tomography, positron emission tomography/computed tomography, and diagnostic laparoscopy. Proximal and mid-body tumors are treated with total gastrectomy with Roux-en-Y esophagojejunostomy. Surgeons at our institution currently do not perform proximal gastrectomy due to concerns over severe reflux and gastroparesis. Tumors in the distal body and antrum of the stomach are typically resected via subtotal gastrectomy with reconstruction either by a Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. This chapter outlines standard open methods for subtotal gastrectomy and total gastrectomy and reconstruction techniques.
| Original language | English (US) |
|---|---|
| Title of host publication | Gastric Cancer |
| Subtitle of host publication | Principles and Practice |
| Publisher | Springer International Publishing |
| Pages | 199-210 |
| Number of pages | 12 |
| ISBN (Electronic) | 9783319158266 |
| ISBN (Print) | 9783319158259 |
| DOIs | |
| State | Published - Jan 1 2015 |
Keywords
- Billroth II gastrojejunostomy
- Operative technique
- Roux-en-Y esophagojejunostomy
- Roux-en-Y gastrojejunostomy
- Subtotal gastrectomy
- Total gastrectomy
ASJC Scopus subject areas
- General Medicine