GASTROCOLIC RESECTION FOR CANCER - RETROSPECTIVE ANALYSIS OF IMMEDIATE POSTOPERATIVE COURSE AND SURVIVAL IN 18 PATIENTS

  • 1 January 1989
    • journal article
    • research article
    • Vol. 43  (7) , 530-536
Abstract
Eighteen patients under gastrocolic resection for cancer. Thirteen had primary gastric cancer and 5 had primary colon cancer (two of these 5 patients had local-regional recurrence after right hemicolectomy). Twelve resections were curvative and 6 palliative. Twelve patients had more than 2 organs resected. Involvement of adjacent tissues of organs was present in 15 patients (11/13 gastric cancer and 4/5 colon cancer: 83%). All patients had immediate colonic anastomosis. The mean duration of post-operative stay was 22 .+-. 8 days (SD). Mortality was 5.6% (1/18). Seven patients had post-operative complications (41%; 7/17); 3 of these 7 patients had anastomotic leakage (one colonic and two pancreatic fistulae; 3/17: 17.6%); the mean duration of post-operative stay for these three patients was 27 .+-. 4 days (p < 0.004). One colonic fistula complicated the 18 colonic anastomoses (5.5%). There was no reoperation in this series. The estimated 2-year survival for the entire group was 20%. The median survival was 9.5 months, the median survival was 13.5 months after curative resections and 5 months after palliative procedure (p < 0.01). The median survival was 8 months for gastric adenocarcinoma and 36 months for colon adenocarcinoma (p < 0.05). Despite the poor results in gastric cancer extending to adjacent organs, complete excision is still recommended whenever feasible. Complete excision of advanced colon cancer may lead to disease-free survival depending on the lymph node status. With an acceptably low mortality, resection remains a better procedure the palliative diversion or exclusion for these advanced tumours.

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