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作者对比观察不同病期和生物学行为胃癌的Ｒ２、Ｒ３手术疗效，探讨合理选择两种术式的适应证。结果表明：ＴＮＭⅠ期（Ⅰ３、Ⅰｂ、）Ｒ２、Ｒ３术后５年生存率基本相同，Ｒ２即可根治。Ⅱ、Ⅲａ期，Ｒ３优于Ｒ２。Ⅲｂ、Ⅳ期胃癌，Ｒ３仍比Ｒ２的５年生存率提高２５．５％。早期癌及ＢｏｒｒｍａｎｎⅠ、Ⅱ型者两组相似，Ｒ３对ＢｏｒｒｍａｎｎⅢ、Ⅳ型癌可提高根治的疗效。Ⅰａ、Ⅰｂ期的胃壁内癌，淋巴结转移限于第一站者，Ｒ２即可达到根治；Ⅱ期以上侵透浆膜者，Ｒ３手术辅助防治腹膜转移的措施仍可提高５年生存率。病理学的弥慢性生长方式、未分化癌及淋巴管癌栓者、生物学行为较差，对进行期病例，应选择Ｒ３扩大淋巴结清除术。
The authors compared the surgical outcomes of R2 and R3 in different stages of disease and biological behaviors of gastric cancer, and explored the rational choice of the two types of surgical indications. The results showed that the 5-year survival rate after TNMI (I3, Ib, R2, R3) was basically the same, and R2 could be cured. Phase II, IIIa, R3 is better than R2. In patients with stage IIIb and IV gastric cancer, the 5-year survival rate of R3 is still 25.5% higher than that of R2. Early cancer and Borrmann I and II were similar in both groups. R3 could improve the curative effect of Borrmann III and IV cancers. In stage Ia and Ib cancers of the gastric wall, lymph node metastasis is limited to the first station, R2 can achieve radical cure, and those who invade the serosa during stage II or above, R3 surgery to help prevent peritoneal metastasis can still improve the 5-year survival rate. The chronic pathological growth pattern, undifferentiated carcinoma, and lymphatic vessel tumor thrombus were poor and biological behaviors were poor. For patients with progressive disease, R3 enlarged lymph node dissection should be selected.