title: Free perforation of gastric carcinoma. Results of surgical treatment.
abstract: OBJECTIVE
  To define by actual standards the results of treatment of free perforation of gastric carcinoma in a consecutive number of patients treated at one institution.
  
  
  METHODS
  Case series of patients with perforated adenocarcinoma of the stomach treated in Hong Kong between 1984 and 1992.
  
  
  METHODS
  Urban academic medical center.
  
  
  METHODS
  Thirty-four Chinese patients who were operated on for perforated gastric carcinoma. A risk scoring system was used to predict postoperative mortality. Factors with a possible influence on postoperative mortality and long-term survival were studied using univariate and multivariate analysis.
  
  
  METHODS
  All patients underwent laparotomy, which was performed for closure of the perforation in four patients and for gastrectomy in 30.
  
  
  METHODS
  Thirty-day mortality and survival times.
  
  
  RESULTS
  The 30-day mortality rate was 20%, and the median survival time was 10 months (range, 2 to 92 months). The risk score was the only significant predictor of 30-day mortality, and the pathologic TNM staging, of long-term survival.
  
  
  CONCLUSIONS
  A significant proportion of patients can be saved and offered good palliation with emergency gastrectomy; those likely to die can be identified before surgery.
authors.affiliation: Department of Surgery, Queen Mary Hospital, University of Hong Kong.
authors.forename: P
authors.initials: P
authors.lastname: Gertsch
authors.forename: S K
authors.initials: SK
authors.lastname: Yip
authors.forename: L W
authors.initials: LW
authors.lastname: Chow
authors.forename: I J
authors.initials: IJ
authors.lastname: Lauder
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005402:Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D005747:Gastric Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006723:Hong Kong; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate