Chirurgia Cancerului Gastric–Analiza A 110 Cazuri

Abstract

Introduction: The current trend for the modern treatment of gastric cancer it is represented by radical surgery with extended lymphadenectomy. The lymphadenectomy, as defined by the Japanese surgeons, is an important, already proved, marker for the overall and disease free survival, but is associated with a risk of postoperative morbidity and mortality. Aim: The aim of the study was to analyze the gastric cancer surgery evaluating the postoperative morbidity and mortality. Material and Method: We performed an observational study, on 110 patients with gastric cancer operated in the Emergency Clinical Hospital BucureE™ti. We also included in our study the tumors located at the gastro-oesophageal junction (that proved by histopathology exam to be of gastric origin) and the tumors of the remnant stomach. RESULTS: The men to women ratio was 1.5 and the mean age was 65.02 ± 11.04 years old. The gastric cancer is located in the 1/3rd upper part in 20.90% cases, and on the distal 2/3rd in 68.17%. Almost half of the patients (48.18%) were admitted with complications (bleeding, stenosis and/or perforation). 25.54% from the patients had distant metastasis (liver, peritoneum, pulmonary, or/and lymphnodes). All the cases were advanced or locally advanced gastric cancer and no case of early gastric cancer has been noted. Most of our surgical interventions were standard resections: total or distal gastrectomy associated with D1 lymphadenectomy in 64 cases and D2 in 32 cases. The mean operative time was 182.3 ± 99 minutes. The overall mortality rate was of 4.5%. The type of lymphadenectomy wasn’t a risk factor for postoperative mortality. Conclusions: The gastric cancer is diagnosed, most commonly, in an advance stage. However, the trend is to perform radical or potentially radical gastrectomies associated with D1 or D2 lymphadenectomy. The type of lymphadenectomy is not a risk factor for postoperative morbidity and mortality.