Principles of radical surgery in gastric carcinoma.

The principles of radical surgery for gastric carcinoma are discussed on the basis of 102 patients treated between 1985 and 1988. Early gastric carcinomas accounted for 11.8% of the cases. Tumor stage, localization and histopathological Lauren grading were the most important parameters influencing the decision on the extent of the excision. Thirteen (22.4%) of the 58 operations done with curative intent were subtotal gastrectomies for small antral tumors. The remaining 45 patients required total gastrectomy with splenectomy. A lymphadenectomy of compartment II was obligatory in all radical procedures. Despite high co-morbidity of the patients the postoperative mortality was 3.1% for total gastrectomy, 4.8% for subtotal gastrectomy and 6.3% for palliative bypass procedures.