title: Gastric cancer perforation: experience from a tertiary care hospital.
abstract: BACKGROUND
  Gastric cancer perforation can occurs in advanced stage of the disease and is often associated with a high morbidity and mortality. Peritonitis due to perforation needs emergency laparotomy and different surgical procedures can be performed for definitive treatment. Surgical procedures largely depend on the stage of the disease and general condition of the patient. This study was carried out to evaluate the outcome and role of different surgical procedures in gastric cancer perforation.
  
  
  METHODS
  Medical record of patients with gastric perforation, who were treated during ten years period, was reviewed retrospectively. Data regarding clinical presentation, surgical procedures, staging and survival of patients were obtained.
  
  
  RESULTS
  Features suggestive of diffuse peritonitis were evident in all cases. The majority of the patients underwent emergency surgery except one who died during resuscitation. The majority of patients were in stage III and stage IV. Surgical procedure includes simple closure and omental patch in five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patients and Devine's antral exclusion in one patient. Surgical site infection was the most common (45.5%) postoperative complication. Four patients died within one month of the surgery. Three patients who underwent gastrectomy survived for one year and one patient survived for five years.
  
  
  CONCLUSIONS
  Although gastric cancer perforation usually occurs in advanced stage of the disease, curative resection should be considered as far as possible.
authors.affiliation: Department of Surgery, Tribhuvan University Teaching Hospital.
authors.forename: Bishnu Prasad
authors.initials: BP
authors.lastname: Kandel
authors.affiliation: Department of Surgery, Tribhuvan University Teaching Hospital.
authors.forename: Yogendra
authors.initials: Y
authors.lastname: Singh
authors.affiliation: Department of Surgery, Tribhuvan University Teaching Hospital.
authors.forename: Keshav Prasad
authors.initials: KP
authors.lastname: Singh
authors.affiliation: Department of Surgery, KIST Medical College, Kathmandu, Nepal.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Khakurel
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D004630:Emergencies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010538:Peritonitis / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D062606:Tertiary Care Centers