Oesophagogastrectomy and total gastrectomy for carcinoma of the stomach : a plea for subdiaphragmatic resection
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Carcinoma of the stomach which involves the gastro-oesophageal junction or cardia is usually advanced by the time the diagnosis is made; resection is therefore often only palliative in nature. Resection is usually performed by a thoracoabdominal incision. Unfortunately there is a high risk of anastomotic leakage after a total or subtotal proximal gastrectomy and if this occurs within the chest mortality and morbidity are very high. In this article a plea is made for a purely abdominal approach.