Surgical Treatment of Perforated Gastric Cancer

Miura, Toshio; Ishii, Toshiyo; Shimoyama, Takatoshi; Hirano, Toshio; Tomita, Masaru

doi:10.1159/000171705

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…However, viable free cancer cells have not been demonstrated in the peritoneal cavity of patients with perforated gastric cancer and the metastatic efficiency of gastric cancer cells possibly shed during perforation is uncertain in the presence of the peritonitis; different studies, included the present one, report of long-term survivors[ 19 ]. When a curative operation can be performed, survival rates after gastric cancer perforation[ 1 , 20 ] appear similar to survival rates observed in elective patients[ 21 , 22 ]. Moreover, Gertsch et al demonstrated how the only factor predicting long term survival is the TNM stage, while age or the size, the location, the depth of infiltration and the histologic grading of the tumor or a delay in treatment after perforation showed no correlation with long-term survival[ 10 ].…”

Section: Discussionmentioning

confidence: 98%

Perforated gastric carcinoma: a report of 10 cases and review of the literature

et al. 2006

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Perforation usually occurs in advanced stages of gastric cancer; nevertheless surgeons should not be always discouraged from a radical treatment of perforated gastric cancer, since perforation even occurs in early stages and seems not to be a negative prognostic factor itself. When possible, emergency gastrectomy should be performed, leaving repair surgery for unresectable tumors. A two-stage treatment is a good treatment option for frail patients with resectable tumors.

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Section: Discussionmentioning

confidence: 98%

Perforated gastric carcinoma: a report of 10 cases and review of the literature

et al. 2006

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“…10 Perforation of gastric cancer does not preclude long-term survival per se in a substantial number of patients. 5,6 In patients who underwent curative resection survival rate is influenced by the stage of the disease and it is similar to those without perforation and underwent elective surgery. 10,17 Lee et al found that potentially curative resection; TNM stage, and the absence of postoperative complications are the important factors associated with improved survival.…”

Section: Discussionmentioning

confidence: 99%

“…When a gastric perforation is encountered during laparotomy, malignant perforation should be suspected as 10-16% of gastric perforation is caused by gastric cancer. 3,5,6 In presence of diffuse peritonitis intraoperative diagnosis of the cancer is often difficult particularly when frozen section evaluation is not available. Peritoneal seedlings and clinical staging may be misinterpreted due to inflammation.…”

Section: Discussionmentioning

confidence: 99%

Gastric Cancer Perforation: Experience from a Tertiary Care Hospital

Kandel

Singh

et al. 2013

J Nepal Med Assoc

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Introduction: Gastric cancer perforation can occurs in advanced stage of the disease and is oftenassociated with a high morbidity and mortality. Peritonitis due to perforation needs emergencylaparotomy and different surgical procedures can be performed for definitive treatment. Surgicalprocedures largely depend on the stage of the disease and general condition of the patient. Thisstudy was carried out to evaluate the outcome and role of different surgical procedures in gastriccancer perforation.Methods: Medical record of patients with gastric perforation, who were treated during ten yearsperiod, 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 thepatients underwent emergency surgery except one who died during resuscitation. The majority ofpatients were in stage III and stage IV. Surgical procedure includes simple closure and omental patchin five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patientsand 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 whounderwent 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._______________________________________________________________________________________Keywords: gastric cancer; gastrectomy; laparotomy; perforation; peritonitis.

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“…Such emergencies are rare in Japanese patients because most Japanese patients have their cancer detected at an of early stage. Perforation has been widely reported to occur in 0.56 to 3.9% of all cases of gastric cancer [1][2][3][4][5], and major bleeding has been reported to occur in as many as 5% of patients [6][7][8]. These emergencies are also rare in the West, and have been described in only a small number of reports in the English literature over the past 20 years [1][2][3][4][5]9].…”

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confidence: 99%