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July 1947


Author Affiliations

From the Department of Surgery, University of Michigan.

Arch Surg. 1947;55(1):13-30. doi:10.1001/archsurg.1947.01230080016002

BY DEFINITION total gastrectomy is the removal of the entire stomach along with a cuff of esophagus, above, and of duodenum, below. Such an operation has now become accepted as a recognized surgical procedure for the treatment of certain lesions of the stomach which cannot be dealt with adequately by partial or subtotal gastrectomy. The lesions which most often require complete gastrectomy are those carcinomas or lymphosarcomas which involve the greater part of the stomach. From the technical standpoint the small "leather bottle" stomach, or linitis plastica, due to a diffuse infiltrating scirrhous carcinoma, has generally been regarded as the type best suited to this operation. In addition, smaller malignant neoplasms situated in the upper half or upper third of the stomach are best treated by total gastrectomy. Large neurofibromas. or leiomyomas with or without sarcomatous degeneration which extend into the upper portion of the stomach are particularly favorable for

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