title: [Complications and risks in the surgery of tumors of the upper digestive tract (Foregut) Part II : Stomach].
abstract: BACKGROUND
  The aim of the work is to evaluate acceptable mortality and morbidity associated with stomach resections for carcinoma.
  
  
  METHODS
  The work analyzes data of patients with gastric cancer from the Czech National Cancer Registry and compares personal experience with complications and risks associated with stomach resections for carcinoma with the data from specialized literature from recent years.
  
  
  RESULTS
  The incidence of gastric cancer in the Czech Republic is presently 15.1/100 000 inhabitants, the mortality 11.6 and the prevalence 48.3. Stomach resections for carcinoma are complicated operations. Despite improving surgical techniques and tactics, as well as the perioperative intensive care, this procedure remains associated with significant morbidity and mortality. At the Department of Surgery of the Oncological Center and Hospital Nový Jičín, 286 patients with gastric cancer were operated between the years 2005 and 2012. In the group of 172 radical R0 resections, the mortality was 3.5% and the total morbidity was 33.7%. The most frequent and significant postoperative surgical complications were the pancreatitis (4.7%) and the anastomotic dehiscence (3.5%). The most frequent non-surgical ones were respiratory complications (4.7%). The mortality and morbidity frequency is comparable with the data published in specialized literature. Surgical treatment also utilized laparoscopy. All operations began with a diagnostic laparoscopy to specify the stage of the disease and to select the laparoscopic approach, most often a laparoscopically-assisted resection, which was used in 60 patients (30%). Laparoscopy was preferred even for the palliative anastomoses. No significant differences in morbidity and mortality were seen between open and laparoscopic procedures and statistical analysis is planned to gain greater experience.
  
  
  CONCLUSIONS
  In the Czech Republic, surgical treatment of tumors of the stomach is currently performed at a large number of workplaces with a low frequency. General trends for improving the morbidity and mortality include the use of minimally-invasive approaches, a fast-track program, and the application of principles of High-volume centres. The long-term prognosis of patients with gastric cancer is principally dependent on the degree of advancement of the disease.
authors.forename: L
authors.initials: L
authors.lastname: Adamčík
authors.forename: M
authors.initials: M
authors.lastname: Duda
authors.forename: M
authors.initials: M
authors.lastname: Skrovina
authors.forename: T
authors.initials: T
authors.lastname: Jínek
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D018153:Czech Republic / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*