Review Article - Conservative surgery in cancer of the stomach and the current status of lymph node dissections

Partial gastrectomy, as described by Polya in 1911 has been practised widely.¹ However, a recommendation for more radical operation was given by McNeer et al² after their review of 92 postmortem examinations following partial gastrectomy for gastric cancer. In half the cases they found recurrence in the gastric remnant and therefore advised radical total gastrectomy with partial pancreatectomy and splenectomy. However, a study at Mayo Clinic analysing the long-term results following total gastrectomy in 170 cases, in which 78 % had involved nodes, showed a five-year survival of only 18 %.³ Only 10 % of the patients with a malignant lesion in the distal part of the stomach lived for five years. These results indicated that total gastrectomy was not the operation of choice for all gastric carcinomas.