Surgical aspects of treatment cancer of the distal part of the stomach, Complicated by perforation, stenosis and acute bleeding
DOI:
https://doi.org/10.11603/2414-4533.2022.2.13167Keywords:
cancer of the distal part of the stomach, surgical treatment; stenosis, perforation, acute bleedingAbstract
The aim of the work – to improve the results of surgical treatment of cancer of the distal part of the stomach, complicated by perforation, stenosis and acute bleeding.
Materials and Methods. In the period from 2006 to 2020, 766 patients with malignant stomach tumors were treated at the clinic, which were complicated by acute bleeding, stenosis or perforation of tumors, which was 2.5 % of all patients treated for gastrointestinal bleeding during the work of the center. Cancer of the distal part of the stomach occurred in 247 (32.2 %) patients, among whom the course of the disease was complicated by the development of acute bleeding in 193 (78.1 %); bleeding and stenosis – in 103 (41.7 %); perforation – in 54 (21.9 %); perforations and stenosis – in 35 (14.2 %); bleeding, perforations and stenosis – in 28 (11.3 %). The age of 173 (70.0 %) men and 74 (30.0 %) women was from 19 to 90 years, and the largest number of patients was noted in the age groups of 61–70 years – 76 (30.7 %) and 71–80 years – 62 (25.1 %) patients. The ratio of men to women was 2.4:1.
Results and Discussion. In total, out of 247 patients, 115 (46.6 %) were operated on: on the background of bleeding – 61 (53.0 %); bleeding and stenosis 52 (45.2 %); perforations – 54 (46.9 %); perforations and stenosis – 35 (30.4%); bleeding, stenosis and perforation – 28 (24.3 %). In the group of patients with newly diagnosed cancer, operative activity was 49.2 % (63 out of 128). Radical operations were performed in 81 (70.4 %) patients, palliative and symptomatic operations were performed in 34 (29.6 %) patients. Lymphodisection D1 was performed during 7 (8.6 %) radical operations, D2 – 74 (91.4 %). The total postoperative mortality was 6.9 % (8 patients). 4 (3.5 %) patients died after radical surgical interventions, and 5 (14.7 %) – after palliative and symptomatic operations. Five-year survival after radical surgery was 44.5 %, and 10-year survival was 8.9 %, with a median survival of 29 months.
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