The application of the operation according to the method Billroth-I in cancer patients: past and present

Abstract

Surgery that involves complete removal of the tumor remains the only method which gives hope for cure of the patient, despite the significant number of combined and complex treatment methods of this disease. However, many provisions of this concept have changed drastically. It is shown that most authors today recommend after resection of the stomach to restore, if possible, the natural anatomical relationship, which provides the best functional results. At the same time noted that some researchers prefer the second method Billroth, some of them are staunch opponents of resection of the stomach according to the method Billroth-I in cancer. This opinion is based on the assumption that resection of the stomach according to the second embodiment Billroth better allows radicalism in the treatment of malignant neoplasms of this localization. The main constraint to the use of the most physiological surgery is the conventional wisdom about supposedly her cancer nerdycellist. The author substantiates the position that the intervention in the modification operations according to the method Billroth-I does not increase the number of postoperative complications, no differences in long-term results of surgical treatment of gastric cancer for two methods of reconstruction of digestive tract continuity after Subtotal distal resection. At the same time, the quality of life of patients better after the reconstruction of the digestive tract with gastroduodenal anastomosis. Exploring the indications for distal Subtotal gastrectomy according to the method Billroth-I, the majority of authors deem this method of restoring continuity of the gastro-intestinal tract only when early cancer, exophytic forms (I – II stage), located in the angle of the stomach or lower third of his body, and the absence of metastases in regional lymph nodes.