The authors describe 694 patients who underwent operation in 1985-1993 for carcinoma of the proximal part of the stomach with various degree of involvement of the adjacent parts of the stomach and esophagus. The tumors differed in histological structure. The main principles of classification of the groups of regional lymph nodes, taking into account the localization of the tumor in the stomach, are shown. These Principles are applied by Japanese surgeons in performing lymph node dissection and were modified in the Clinic od Thoracic Oncology of the Scientific Research Institute, Oncological Center, Russian Academy of medical Sciences. The localization and incidence of metastases in disseminated carcinoma of the proximal stomach with involvement of the esophagus were studied. The sequence of the stages of intraabdominal lymph node dissection in proximal gastric resection and gastrectomy is discussed. The tendency towards improvement on the indices of 3-year survival after expanded operations is noted. Expanded operations with scrupulous morphologic examination of the removed lymph nodes is very important for more precise determination of the stage and individual prognostication of the choice of the postoperative methods of treatment. In palliative interventions the operation is cytoreductive in essence and may create to a certain measure better conditions for chemotherapy.

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