THE COMPARATIVE ASPECTS OF TWO MODIFICATIONS OF GASTRIC RESECTION ACCORDING T. BILLROTH TECHNIQUE IN ONCOLOGIC PRACTICE

Abstract

The surgical intervention implying total ablation of tumor, continues to be the only method giving hope for recovery of patient despite a significant number of combined and complex methods of treatment of the given disease. However, many positions of the given conception underwent cardinal changes. Nowadays, most of authors recommend after gastric resection to restore to the extent possible natural anatomic relationships that provides best functional results. At the same time, certain researchers give preference to Billroth-II mode and at that some of them are devoted opponents of gastric resection by Billroth-I mode in case of cancer. This opinion is based on supposition that gastric resection by Billroth-II mode provides in greater extent radicalism in case of treatment of malignant neoplasms of given localization. The main factor restraining application of this most physiological operation is established opinion alleging its oncologic non-efficacy. The thesis is substantiated that intervention into modification of operation according Billroth method does not result in increasing of number of post-operative complications and that there is no differences also in distant results of surgical treatment of gastric cancer in case of application of both modes of restoration of continuity of digestive tract after sub-total distal resection. At the same time, quality of life of patients becomes better after reconstruction of digestive tract using gastroduodenal anastomosis. Most of researchers, studying indications to sub-total gastric resection using method Billroth-I, assume that it is reasonable to apply this particular mode of restoration of continuity of gastrointestinal tract only in case of early cancer, its exophytic forms (stage I and II) located in area of stomach angle or its low one third of its body and absence of metastases into regional lymphatic nodes.