[The clinical, diagnostic and therapeutic characteristics in antral gastric cancer]. / Particularitati clinice, diagnostice si terapeutice în cancerul gastric antral.

This paper is part of a comprehensive study on subphrenic digestive cancer carried out between 1984 and 1988, representing the experience of the III-rd, I-st, IV-th and emergency surgical clinics of Iasi (1530 cases). The peculiarities of gastric cancer with antral site in 231 out of a total of 612 cases, representing the experience of the III-rd Surgical Clinic, are presented. Clinically, the relative early occurrence of the symptoms, the need for an endoscopic examination and biopsy for all gastric ulcer lesions, for the antral ones particularly, are mentioned. The treatment is surgical, but it has to be associated with adjuvant therapy. For the antral site, the oncological subtotal gastrectomy was the surgery of choice (157 cases), the need of restoring the transit in a gastrojejunal manner being underlined. Total gastrectomy was performed in 12 cases.

[Cancer of the upper gastric pole--possibilities and limitations]. / Cancerul polului superior gastric--posibilitäti si limite.

An analysis of the cases encountered over the last 5 years revealed a high frequency of gastric cancers located in the upper pole area of the stomach. These represented 23% of all gastric cancers. The low number of cases with this localization that could benefit from gastric resection (38,7%), in contrast with distal locations (65,4%) suggest either late detection or high invading potential of these cancers. Oeso-gastric resection - the only efficient curative or palliative treatment - was adapted according to site and extension of the tumour in both organs. In 6 cases partial resection of the thoracic oesophagus was necessary, and in another 4 cases total gastrectomy was performed. In 8 patients upper polar resection - including the oesophagus - was satisfactory from the oncologic viewpoint, and was well-tolerated by the patients.

[Gastric stump cancer]. / Cancerul de bont gastric.

The cases of gastric stump cancer recorded at the III-rd Surgical Clinic of Iaoi during the last 5 years are analysed. Based upon the personal experience and data in the literature 7 cases are discussed. Out of the 7 cases, in 3 an initial resection for gastric ulcer and in 4 for duodenal ulcer was performed 17-40 years previously (with an average of 26 years). All the patients presented Bilroth II anastomoses. The diagnosis was determined by radiological, endoscopic and endobioptic examinations after a mean interval of 10 month since the occurence of the clinical symptoms. The site of the lesion was the following: in 3 cases on the anastomosis line and in 4 on the reminder of the stump. Out of the 7 cases, 5 were operable and in 4 the resection was completed. Two days post-operatively a death was recorded. The conclusions of this paper insist upon the fact that the occurance of the tumor on the gastric resection stump mainly depends on the initial lesion (gastric lesion) and less on the type of anastomosis. The long-term surveillance of the gastric resection patients is thus essential.