The main treatment is surgical resection of early stage non-metastatic gastric cancer. However, the optimal size of nodal resection, D2, D1 dissection procedure, indicating not improve survival compared with randomized trials are currently under discussion due. Complete resection of the tumor and the surrounding nodes, the only chance for cure, though, much of the United States, 90% of patients with gastric cancer at diagnosis, advanced stage. To use the type of surgical procedure, tumor size, and layout sets (42). Effective for pathologic staging of regional lymph node removal of at least 15 the desired number. One of the most important aspects of surgery is to obtain a negative surgical margin. Only the mucosa and submucosa, defined as carcinoma limited to the high cure rate of early gastric cancer, lymph node metastases may occur in 15% despite 10-D1, and D2 lymphadenectomy with gastrectomy in Japan is still seen as the best treatment to be selected. However, only the selection of patients to endoscopic mucosal resection, tumor size, differentiation, and defined criteria, such as the depth of submucosal invasion. Stage IV patients, surgery, palliation, and passage only applied to problems
Tumors Proximal: Proximal tumors are responsible for 50% of all gastric cancers. This advanced stage tumors are caught and distal cancers have a worse long-term prognosis. There are three types of tumor of the gastroesophageal junction according to Siewert classification: Type I Barrett's esophagus or gastroesophageal junction with the right growing real-esophageal cancer, type II cancers, the squamocolumnar junction, and type III tumors of 2 cm on the actual junction of the stomach cancers are located in the region. Type II and III cancers, the most appropriate surgical treatment remains controversial. Options proximal subtotal gastrectomy and total gastrectomy. Cardia due to the advanced stage at diagnosis, total gastrectomy, some authors, especially to prolong the prognosis in patients with stage II and IV discuss the implementation of the most simple proximal subtotal gastrectomy. However, in some studies, proximal subtotal gastrectomy, total gastrectomy shows that there is lower than the quality of life. MD Anderson proximal gastric lesions and regional lymphadenectomy, total gastrectomy with Roux-NY applied. Total gastrectomy and proximal gastrectomy in the prevention of reflux, and often held easy removal of the lymph nodes around the lesser curvature is provided, according to the proximal gastrectomy in more morbidity and mortality has been observed.
Medium body and distal tumors: tumors of the stomach in the middle of 15-stomach cancer makes up 30%. Regional lymphadenectomy and total gastrectomy with proximal tumors, the approach is recommended for similar reasons. Responsible for approximately 35% of tumors of the distal stomach tumors. These lesions distal subtotal gastrectomy with lymphadenectomy is the standard appropriate. This is because the rule of survival of total gastrectomy and subtotal gastrectomy and subtotal gastrectomy Patients recovering from a better quality of life and is not showing. Also, if possible, surgical resection margin is recommended 5-6 cm