Indications and Results of Palliative Gastric Resection in Advanced Gastric Carcinoma

作者：Dittmar Y; Volgt R; Heise M; Rabsch A; Jandt K; Settmacher U^*

来源：Zentralblatt fur Chirurgie, 2009, 134(1): 77-82.

DOI：10.1055/s-0028-1098793

• palliative gastrectomy
• advanced gastric cancer
• survival
• quality of life

Background: Gastric carcinoma is often diagnosed at UICC stage 3 b or 4. R0 resection can be achieved only in very few such cases. Even for these patients the 5-year survival rate is less than 5%.. Surgical palliation is traditionally reserved for the treatment of severe tumour complications not responding to other forms of treatment.
Patients and Methods: We report on 21 patients who underwent palliative resection for gastric carcinoma at our institution between 2004 and 2007. Ten of these were assigned to palliative surgical treatment pre-operatively while this choice was made for 11 patients on the grounds of the intra-operative findings. We performed 17 gastrectomies, 3 proximal gastric resections and one distal gastric resection.
Results: it has been shown that the patients have an improved overall survival time as compared to patients who received non-surgical treatment. The perioperative risk was reasonable when patients were carefully selected. Median survival for resected patients was 16 months. 80% of patients were alive after 6 months and approximately 60% of patients were alive after 12 months. The perioperative mortality was 0% with a mean hospital stay of 12 days. All patients were discharged home with proper bowel passage and analgesia as individually required.
Conclusions: We are convinced that palliative gastric resection provides a pronounced Survival benefit over any other palliative treatment options. Patients also have an improved quality of life.

• 出版日期2009-2