Perforation of gastric cancer - What should the surgeon do?

  • Nebojsa Ignjatovic Clinic of General Surgery, Clinical Center Nis, Nis, Serbia School of Medicine, University of Nis, Nis, Serbia
  • Dragan Stojanov Clinical Center Nis, Nis, Serbia School of Medicine, University of Nis, Nis, Serbia
  • Miodrag Djordjevic School of Medicine, University of Nis, Nis, Serbia
  • Jelena Ignjatovic School of Medicine, University of Nis, Nis, Serbia
  • Daniela Benedeto Stojanov School of Medicine, University of Nis, Nis, Serbia
  • Bobana Milojkovic Clinic of General Surgery, Clinical Center Nis, Nis, Serbia
Keywords: Gastric cancer, surgery, perforation, survival

Abstract

Perforation represents a rare and severe complication of gastric cancer (GC) with a large hospital mortality (8-82%). The aim of this study is to evaluate the clinical-pathological features in patients with perforated gastric cancer (PGC) and to advise the surgical treatment options. A total of 11 patients with PGC were retrospectively reviewed among 376 consecutive cases of GC operated. The clinical-pathological features including tumor stage, survival, and the type of treatment were observed. The perforation was more frequent in stage III (8 patients) and in stage IV (3 patients), but none of the cases in stage I and II GC were observed. All the patients had serosal invasion and lymph node metastasis. Limited lymphadenectomy (D0, D1) was performed in 5 patients, and extended lymphadenectomy (D2, D3) in 3 patients. Emergency gastrectomy was performed in 8 (72.8%) patients, subtotal gastrectomy in 5 (45.5%), and total gastrectomy in 3 (27.2%) cases. Three (27.2%) patients were treated by simple closure with omental patch. The overall 30-day mortality rate was 46%. The survival rate was higher among the patients who underwent curative resection (75.77±68.88 days) than in those who underwent simple closure with omental patch (18.00±24.43 days). The difference between the treatments in these groups was significant (p < 0.05). PGC required surgical emergency. Curative resection improved long-term survival in the patients with potentially curable gastric malignancy. Unsuccessful outcomes after PGC could be attributed to the poor condition of the patients and the advanced disease stage.

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Published
2016-07-02
How to Cite
1.
Ignjatovic N, Stojanov D, Djordjevic M, Ignjatovic J, Benedeto Stojanov D, Milojkovic B. Perforation of gastric cancer - What should the surgeon do?. Bosn J of Basic Med Sci [Internet]. 2016Jul.2 [cited 2019Nov.14];16(3):222-6. Available from: https://bjbms.org/ojs/index.php/bjbms/article/view/1020
Section
Translational and Clinical Research