Strategic aspects of stomach cancer surgery.

The aim of the research is to study both immediate and long-term results of treatment in patients with gastric cancer after extended and expanded-combined gastrectomy; assessment of quality of life of patients, depending on the methods of reconstruction. 90 extensive and extensively-combined gastrectomies have been performed. 23 patients have been given operations with overlaying reservoirs at the reconstructive stage. The post-operational complications were observed among 18 (20%) patients in the main group, mortality was constituted 5 (5,6%). In the control group the above mentioned rates was constituted 14 (17,1%) and 3 (3,37%) correspondingly. The difference between the obtained data is statistically non-authentic (p>0,05). Reflux-oesophagitis was detected among 17 (25,37%) patients after standard reconstructions and 2 (7,69%) - after overlaying the reservoirs (p<0,01). In the main group an annual disease free period constituted 94,11%, 3-year - 58,82%, in the control group - 73,2% and 32,9%, respectively. 3- and 5-year survival rate in the main group constituted 70,59% and 37,65%, in the control group - 47,6% and 13,4% correspondingly (p<0,01). Extensive and extensively-combined gastrectomies improve distant results of the treatment among the patients with stomach cancer and aren't followed by increase in rate of post-operational complications and mortality. Overlaying the reservoirs decrease the rate and intensity of reflux pathology.