Palliative operations for incurable gastric cancer

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Abstract
The experiences of 206 patients who underwent palliative operations for advanced gastric carcinoma have been reviewed to evaluate the effect of treatment. Gastroenterostomy for obstruction alleviates vomiting for most patients, but significant palliation followed operation in only 1/3 of cases. The procedure was accomplished with an acceptable mortality rate, and the average period of postoperative hospitalization was 13 days. The results of palliative partial gastrectomy for patients having obstructive symptoms preoperatively were only slightly better than those following gastroenterostomy. Approximately 1/3 of the patients lived in relative comfort for more than a year. The poor progress of 6 patients who received total gastrectomy supports the opinion that total gastrectomy is not a satisfactory palliative operation. Palliative esophagogastrectomy for patients with dysphagia gave results similar to, or possibly better than, palliative resections for distal lesions. Although the results following the use of prostheses for inoperable malignant stricturing of the esophagogastric junction were disappointing, the procedure had significant advantages when compared with the marked limitations and disadvantages of jejunostomy and the transient relief afforded by transesophageal dilatation. Review of the records of patients who had had a feeding jejunostomy confirmed the general opinion that this procedure seldom is indicated in the management of advanced gastric carcinoma.