Kally, a 60 years old male diagnosed to have carcinoma stomach. CT scan of abdomen showed a mass measuring 4x4 cm in the antrum with involvement of celiac nodes and right gastric nodes. Management of choice
Treatment- Depends on the location of malignancy * Proximal 1/3rdExtended gastrectomy + D2 Lymphadenectomy* Middle 1/3rdTotal gastrectomy + D2 Lymphadenectomy* Distal 1/3rdSubtotal gastrectomy + D2 Lymphadenectomy This treatment is same for both Intestinal & Diffuse variety of CA Stomach- Exception - Diffuse variety involving distal 1/3rd malignancy | Total gastrectomy + D2 Lymphadenectomy. - Indication of distal Pancreatectomy* Involvement of body / tail of pancreas by the tumor -Indications of Splenectomy* Direct involvement of spleen by CA Stomach* CA Stomach in the proximal pa along posterior wall or greater curvature.
Total gastrectomy
Subtotal gastrectomy
Palliative
Chemotherapy
Stomach & Duodenum