{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:03:31Z","timestamp":1761487411264},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[1991,9,1]],"date-time":"1991-09-01T00:00:00Z","timestamp":683683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1991,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Both basic and clinical studies were undertaken to determine the indications for pylorus preserving gastrectomy for patients with early gastric cancer located in the middle third of the stomach. This procedure is different from conventional subtotal gastrectomy in that it retains a 1.5\u00a0cm length of the pyloric cuff and it neglects to dissect the suprapyloric lymph node, with the remaining pyloric branch of the vagal nerve being preserved. Therefore, it is essential that this limited operation be performed only in cases without metastasis to the suprapyloric lymph node. The distance from the caudal end of the tumor to the cut edge is far enough when the tumor is in the middle third of the stomach. The direction of lymph flow, as determined in 14 cases by activated carbon particles (CH\u201040), suggests that there is limited lymph flow towards the suprapyloric lymph node from the middle third of the stomach. Lymph node involvement was investigated in 154 patients with early gastric cancer located in the middle third of the stomach who had undergone conventional subtotal gastrectomy with regional lymph node dissection between 1976 and 1989. By analysis of the relationship between lymph node metastasis and the clinicopathologic findings revealed before operation, i.e. gross appearance, histological classification, and tumor size, the indications for pylorus preserving gastrectomy were determined as follows: (1) any case with tumors smaller than 2.0\u00a0cm in maximum length, and (2) cases with a tumor of 2.0 to 4.0\u00a0cm if it is a mucosal cancer, if it is located at the greater curvature, or if it is an elevated type IIa cancer. This operation has been performed on 11 patients to date without postoperative complaints or sequelae.<\/jats:p>","DOI":"10.1007\/bf01789211","type":"journal-article","created":{"date-parts":[[2005,6,20]],"date-time":"2005-06-20T01:07:52Z","timestamp":1119229672000},"page":"628-633","source":"Crossref","is-referenced-by-count":63,"title":["Indications for pylorus preserving gastrectomy for early gastric cancer located in the middle third of the stomach"],"prefix":"10.1002","volume":"15","author":[{"given":"Masashi","family":"Kodama","sequence":"first","affiliation":[{"name":"Department of Surgery Akita University School of Medicine 1\u20101\u20101 Hondo 010 Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Surgery Akita University School of Medicine 1\u20101\u20101 Hondo 010 Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1991,9]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"838","article-title":"Pyloruspreserving gastrectomy as an improved operation for gastric ulcer","volume":"61","author":"Maki T.","year":"1967","journal-title":"Surgery"},{"key":"e_1_2_1_3_1","first-page":"1572","article-title":"Definition of the adaptation of endoscopic surgery for early gastric cancer, special examination of the relationship between the histological differentiation of the intramucosal gastric cancer and the lymph node metastasis","volume":"24","author":"Karita M.","year":"1989","journal-title":"J. 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