[Evaluation of surgical traumaticity of standard and extended surgical procedures in cancer of a proximal part of the stomach].
Analysis of the results and evaluation of surgical trauma of 454 various resections for cancer of a proximal part of the stomach were carried out. Proximal subtotal resection of the stomach with resection of the esophagus were performed in 151 patients (33.2% of all the resections). Gastrectomy was performed in 296 (65.2%) patients. Standard resection was carried out in 254 (55.9%) patients, extended -- in 72 (15.8%), combined -- in 64 (14,1%), extended-combined -- in 64 (14,1%). It is demonstrated that number of complications after surgical treatment of cancer of a proximal part of the stomach is high enough due to traumaticity of abdominal-thoracic surgical procedures. Surgical approach, duration of surgery, intraoperative blood loss have significant influence on short-term results. Duration of surgery more than 300 min is the main factor making worse short-term results of extended resection of the stomach. In such duration of surgery postoperative complications were seen in 45.0+/-11.4%, lethal outcome -- in 30.0+/-10.5% cases. Extended surgical procedures demonstrate better long-term results. Five-years survival of patients with cancer of proximal part of the stomach (stage II and III) after extended surgeries is 53.3+/-13.3 and 33.3+/-6.3%, respectively. Standard resection is recommended for elderly patients with low functional reserves.
Aĭtaliev
M S
MS
Zemlianoĭ
V P
VP
Nepomniashchaia
S L
SL
D004947:Esophagus / Q000601:surgery; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome