Extent of Gastric Resection

Controversy exists as to the appropriate extent of gastric resection. There are three choices: (1) total gastrectomy, (2) distal subtotal gastrectomy, or (3) proximal subtotal gastrec-tomy. A number of prospective trials have examined the extent of gastric resection comparing total gastrectomy with distal subtotal gastrectomy (Gouzi et al, 1989; Bozzetti et al, 1999). None of these studies showed an improved survival based on the extent of gastric resection, though there was increased morbidity with total gastrectomy. For proximal lesions, total gastrectomy is the traditional choice, although a proximal gastrectomy is reasonable if anatomy allows a tension-free, well-perfused gastric remnant. At Memorial Sloan-Kettering Cancer Center (MSKCC), a retrospective review of a prospectively maintained database comparing proximal subtotal with total gastrectomy for cardia and fundus GCs revealed no difference in survival or morbidity between the two groups (Harrison et al, 1998). For larger lesions or those occupying the entire body of the stomach, total gastrectomy is necessary. For distal body and/or antral lesions, a distal, subtotal gastrectomy is performed.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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