Free Perforation of Gastric Carcinoma

Gertsch, Philippe; Yip, Sydney K. H.; Chow, Louis W C; Lauder, I.

doi:10.1001/archsurg.1995.01430020067011

Cited by 45 publications

(70 citation statements)

References 6 publications

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“…Of those, nine articles were included in this qualitative review of perforated gastric cancer (Table 1) [3][4][5][6][7][8][9][10][11]. Two of the articles report outcomes on the same series of patients; therefore, results are reported together to avoid duplication [6,7].…”

Section: Resultsmentioning

confidence: 99%

“…In 8 of the 9 studies, a preoperative diagnostic status was reported by the authors. On average, fewer than half of the patients presenting with perforation and receiving subsequent treatment had a preoperative or intra-operative diagnosis of gastric cancer [3][4][5][6][7][9][10][11]. Jwo et al [9] reported one patient who experienced perforation during chemotherapy for metastatic disease.…”

Section: Resultsmentioning

confidence: 99%

“…Jwo et al [9] reported one patient who experienced perforation during chemotherapy for metastatic disease. Gertsch et al [4] reported information on preoperative investigations, citing roentgenology and laboratory tests for diagnosis of perforation.…”

Section: Resultsmentioning

confidence: 99%

“…The status of the operation (emergent vs elective) was classified by 5 of the studies and 100% were executed emergently [5,[7][8][9]11]. Gertsch et al [4] reported that 21% of patients were in preoperative shock at presentation while Ozmen et al [3] reported 7/14 patients were in preoperative shock at presentation.…”

Section: Resultsmentioning

confidence: 99%

“…Patient co-morbid status and intra-operative status were not reported by management strategy and this information would have aided understanding. Two-stage operations for improved oncologic outcomes were discussed in 5 studies [3,4,6,7,11]. Citing extreme shock and peritonitis as precluding initial extensive surgery, Ozmen et al [3] performed secondary cancer-related gastrectomy following improved health status of the patient.…”

Section: Long-term Outcomesmentioning

confidence: 99%

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Surgical management of gastric perforation in the setting of gastric cancer

et al. 2011

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Background Gastric perforation is a rare presentation of gastric cancer and is thought to be a predictor of advanced disease and, thus, poor prognosis. Guidelines do not exist for the optimal management strategy. We aimed to identify, review, and summarize the literature pertaining to perforation in the setting of gastric cancer. Methods A qualitative, systematic review of the literature was performed from January 1, 1985, to January 1, 2010. Searches of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were performed using search terms related to gastric cancer surgery. Abstracts were examined by two independent reviewers and a standardized data collection tool was used to extract relevant data points. Summary tables were created.Results Nine articles were included. Perforation was reported to occur in fewer than 5% of gastric cancer patients. Preoperative diagnosis of a gastric cancer was rated and occurred in 14-57% of patients in the papers reviewed. Mortality rates for emergency gastrectomy ranged from 0 to 50% and for simple closure procedures the rates ranged from 8 to 100%. Patients able to receive an R0 gastrectomy demonstrated better long-term survival (median 75 months, 50% 5-year) compared with patients who had simple closure procedures. Conclusions Gastric cancer patients presenting with a gastric perforation demonstrate improved overall survival with an R0 resection; however, implementation of this management technique is complicated by infrequent preoperative gastric cancer diagnosis, and inability to perform an oncologic resection due to patient instability and intraabdominal contamination.

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