| [ Summary ] |
From the viewpoint of lymphatic drainage of the remnant stomach, patients with gastric stump cancer could be classified into two groups. In the first group, the left gastric artery had been preserved in the last gastrectomy, and most patients in this group had have benign disease. In the patients with a preserved left gastric artery, the lymphatic drainage of the remnant stomach proceeded mainly along the left gastric artery. In these patients, extensions of the gastric stump cancer were similar to the primary gastric cancer located in the upper third of the stomach. In the second group, the left gastric artery had been sacrificed for radical lymph node dissection in the last gastrectomy. In patients with a removed left gastric artery, the lymphatic drainage proceeded mainly along the splenic artery. In these patients, lymph node dissection along the splenic artery is critical. Some of patients who had received a Billroth II reconstruction had lymph node metastases in the jejunal mesentery. About half of pati-ents with gastric stump cancer due to cancer recurrence had extensive disease. |