Abstract

During 16 years from Jan. 1970 to Dec. 1986, total gastrectomy and extended total gastrectomy were performed in 566 patients. The results are as follows: 1) Gastrectomy was performe4 in 2891 out of 3791 patients (76%) who underwent operation. 2) Total gastrectomy and extended total gastrectomy were performed in 566 patients (19%) of them. 3) The most frequent site of primary gastric cancer was the body (40. 5%), followed by the cardia and fundus (24.4%), diffuse infiltration of gastric wall (18.1%) and antrum (17.0%). 4) In the cases of advanced carcinoma, the most common Borrmann type was Type III (55.8%), followed by Type IV (18.1%), Type II (17.0%) and Type I (3.4%). 5) Early gastric cancer was 26 cases (5.7%). 6) In the pathologic findings, the most common type was adenocarcinoma (68.9%), followed by mucinous cell (9.7%), signet ring cell (8.6%) and undifferentiated carcinoma (5.7%). 7) In the staging of cancer according to TNM postsurgical-pathologic stage group, stage I was 4. 4%, stage Il 17.4%, stage III 78.2%. 8) In the extended total gastrectomy, partial hepatectomy was performed in 10 cases (8.4%) and transverse colectomy was performed in 10 cases (8.4%) in addition to pancreaticosplenectomy. 9) Overall operative mortality was 3.8% and no significant difference of operative mortality was found between total and extended total gastrectomy. 10) The expected 5 YSR, according to Cohort life table, was 45% in total gastrectomy and 24% in extended total gastrectomy. In the total gastrectomy patients, 5 YSR of stage I, II, Ul were 100%, 68% and 36%, respectively. In the extended total gastrectomy patients, 5 YSR of stage II and III were 48% and 16%, respectively.