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目前对全胃切除手术的指征有两种见解;大多数外科专家主张仅于部分胃切除术不能达到根治目的时施行,另一部分主张全胃切除术作为胃癌的治冶原则。对这一问题的抉择需藉大量病例的观察。作者通过404例由于胃癌而作全胃切除术患者,提供关于手术指征及扩大胃切除疗效的看法。手术死亡率为3.3％,较其它作者报告为低,作者认为主要原因可能是由于手术上的特殊操作方法(支持缝合):在食道与十二指肠直接吻合时于胰腺囊和横隔膜脚之间作支持缝合,食道空肠吻合时在空肠后壁与横膈膜脚之间作支持缝合,而当胸腔内做吻合时则于吻合处和纵隔胸膜作支持缝合。而在采用此种操作前所施行的旧的不完全吻合术式(Inkomplette Anastomose)则死亡率为14.8％。
At present, there are two kinds of insights about the indications of total gastrectomy; most surgical experts advocate that only partial gastrectomy can not achieve the goal of radicalization; another part advocates total gastrectomy as the principle of governing and governing the gastric cancer. The choice of this issue requires the observation of a large number of cases. The authors provided 404 views of patients undergoing total gastrectomy due to gastric cancer, providing insights into the surgical indications and the effect of extended gastrectomy. The operative mortality rate was 3.3%, which was lower than other authors’ reports. The authors believe that the main reason may be due to a special surgical operation (supporting sutures): between the pancreas and the diaphragm foot when the esophagus and the duodenum are directly anastomosed. Support suturing, esophageal jejunal anastomosis between the jejunum posterior wall and transverse aponeurosis foot support suture, and when the intrathoracic anastomosis at the anastomosis and mediastinal pleura support suture. The old Innomplette Anastomose, which was performed prior to this procedure, had a mortality rate of 14.8%.