THE SELECTION OF OPERATION TYPES FOR PATIENTS WITH STAGE I AND II GASTRIC CARCINOMA

From Apr. 1964 to Dec. 1982, one hundred and twenty nine patients win stage Ⅰ and Ⅱ gastric carcinoma underwent two different operation types, at our hospital. A-mong the 14 patien ts in stage Ⅰ . 8 cases underwent R 2 radical gastrectomy, 6 cases underwent subtotal gastrectomy. Their 5- and 10-year survival rates were similar Among the 115 cases in stage Ⅱ 64 cases underwent R 2 operation and 51 cases subtotal gastrectomy. Their 5-year survival rates were similar. However, the 10-year survival rate was somewhat higher in the R 2 group than that in the subtotal gastrectomy group . According to the infiltrating extent of the tumor and metastases of the regional lymph nodss, it seems that the subtotal gastrectomy is reasonable theoretically for stage Ⅰ cases, because there is no metastatic lymph nodes in these patien ts, However, for there patients R 1 radical operation should be chosen in clinical practice, because we could not judge macroscopically whether the lymph nodges are affected. In clinical practice , for the same recason , we could not differ entiate stage Ⅱ with stage, Ⅲ gastric carcinoma. Once the gastric carcinoma is determined clinically to be stage Ⅱ, we prefer to perform R 2 or selective R 3 operation.