[Gastric cancer. Treatment results in 237 patients]

Although current achievements of diagnostic and treatment process, including D II-III gastrectomy and neoadjuvant chemotherapy, the results from the treatment of patients with gastric cancer (GC) are still unsatisfactory. Retrospective study was performed analyzing the early and late results from the treatment of 237 pts admitted in the department with GC. 218 of them underwent operative treatment; 131 men and 87 women, aged between 26-88 years. Patients with esophageal cancer were excluded from the study. In 19 pts preoperative laparoscopy and staging of the process lead to refusal of surgery. The distribution according to clinical stage was: I st.--5; II st.--37; III st.--101 and IV st.--75 patients. Greatest importance for the exact preoperative diagnosis and staging of the process had: Fibrogastroscopy + biopsy; Ultrasonography; CT scan and Laparoscopy. Radical surgery was performed in 119 pts (54.58%). Total gastrectomy--59 /27.06%/, subtotal gastrectomy--36 /16.51%/, gastrectomy + splenectomy + pancreatic resection--14 /6.42%/; gastrectomy + hepatic resection--5; gastrectomy + hemicolectomy--2; gastrectomy + resection of c. transversum--3. The preferred method for reconstruction was Roux-en-Y. Palliative resections were performed in 18 pts. Only Gastroenteroanastomosis was performed in 41 pts. Postoperative morbidity was registered in 41 pts /18.8%/. Most common were wound complications--in 21 /9.61%/, cardio-pulmonal--14 /6.42%/, thromoemboly--3 /1.38%/. Early reoperations--13 /5.96%/ performed in 7 pts. Early postoperative mortality--7 /3.21%/, but for the radical operations it was 5.88%. The major risk factors for the postoperative morbidity and mortality were: coexisting diseases, advanced age, pancreatic resection, splenectomy and extended lymphadenectomy.