RT Book, Section
A1 Roses, Robert E.
A1 Dempsey, Daniel T.
A2 Brunicardi, F. Charles
A2 Andersen, Dana K.
A2 Billiar, Timothy R.
A2 Dunn, David L.
A2 Kao, Lillian S.
A2 Hunter, John G.
A2 Matthews, Jeffrey B.
A2 Pollock, Raphael E.
SR Print(0)
ID 1164316836
T1 Stomach
T2 Schwartz's Principles of Surgery, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259835353
LK accesssurgery.mhmedical.com/content.aspx?aid=1164316836
RD 2024/04/16
AB Key  Points  Whenever  testing  suggests  Helicobacter  pylori  infection,  treatment  should  be  initiated  and  eradication  confirmed.  Lifelong  acid  suppression  should  be  considered  in  any  patient  admitted  to  a  hospital  because  of  peptic  ulcer  disease.  Acid  suppressive  medication  may  be  equivalent  to  surgical  vagotomy  in  preventing  recurrent  peptic  ulcer  or  ulcer  complications.  If  possible,  gastric  resection  for  peptic  ulcer  is  avoided  in  the  asthenic  or  high-risk  patient.  Though  less  common  in  the  United  States,  gastric  cancer  is  a  major  cause  of  cancer-related  morbidity  and  mortality  worldwide.  Diagnostic  laparoscopy  with  peritoneal  lavage  should  be  considered  in  the  evaluation  of  clinical  stage  2  and  3  patients  with  gastric  cancer.  Multimodality  therapy  for  gastric  cancer,  including  resection  in  combination  with  perioperative  chemotherapy  or  adjuvant  chemoradiotherapy  is  associated  with  a  survival  advantage  compared  to  surgery  alone.  Most  patients  with  primary  gastric  lymphoma  can  be  treated  without  gastric  resection.  Localized  gastrointestinal  stromal  tumors  of  the  stomach  are  treated  with  full  thickness  excision.  Adjuvant  (or  neoadjuvant)  imatinib  is  indicated  for  higher-risk  lesions.  Gastric  neuroendocrine  tumors  may  arise  in  the  presence  (types  1  and  2)  or  absence  (type  3)  of  hypergastrinemia.  Type  3  gastric  neuroendocrine  tumors  should  usually  be  treated  with  subtotal  gastrectomy  and  regional  lymphadenectomy.  Roux-en-Y  gastrojejunostomy  with  a  large  (>50%)  proximal  gastric  remnant  should  be  avoided  because  marginal  ulceration  and/or  gastric  stasis  (Roux  syndrome)  may  become  problematic.