[Gastrocolonic excision of cancer. Retrospective analysis of the immediate postoperative course and long-term survival in 18 patients].
Eighteen patients underwent gastrocolic resection for cancer. Thirteen had primary gastric cancer and 5 had primary colon cancer (two of these 5 patients had local-regional recurrence after right hemicolectomy). Twelve resections were curative and 6 palliative. Twelve patients had more than 2 organs resected. Involvement of adjacent tissues or organs was present in 15 patients (11/13 gastric cancer and 4/5 colon cancer: 83%). All patients had immediate colonic anastomosis. The mean duration of postoperative stay was 22 +/- 8 days (SD). Mortality was 5.6% (1/18). Seven patients had post-operative complications (41%; 7/17); 3 of these 7 patients had anastomotic leakage (one colonic and two pancreatic fistulae; 3/17: 17.6%); the mean duration of postoperative stay for these three patients was 27 +/- 4 jours, (p less than 0.004). One colonic fistula complicated the 18 colonic anastomoses (5.5%). There was no reoperation in this series. The estimated 2-year survival for the entire group was 20%. The median survival was 9.5 mois; the median survival was 13.5 months after curative resections and 5 months after palliative procedure (p less than 0.01). The median survival was 8 months for gastric adenocarcinoma and 36 months for colon adenocarcinoma (p less than 0.05). Despite the poor results in gastric cancer extending to adjacent organs, complete excision is still recommended whenever feasible. Complete excision of advanced colon cancer may lead to prolonged disease-free survival depending on the lymph node status. With an acceptably low mortality, resection remains a better procedure than palliative diversion or exclusion for these advanced tumours.
Delpero
J R
JR
Le Treut
Y P
YP
Pol
B
B
Houvenaeghel
G
G
Brandone
J M
JM
Guérinel
G
G
Bricot
R
R
D000328:Adult; D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D013997:Time Factors
Les exérèses gastrocoliques pour cancer. Analyse rétrospective des suites immédiates et de la survie éloignée chez dix-huit malades.