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Updated: May 7, 2026
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
[Surgical treatment of patients with stomach cancer and severe concomitant cardio-vascular pathology]
Insights
This study on gastric cancer patients with severe heart conditions found that simultaneous operations had a 55.6% complication rate and zero deaths, while stepwise treatment had a 45.2% complication rate and 7.1% lethality.
Area of Science:
- Cardiovascular Surgery
- Surgical Oncology
Background:
- Gastric cancer patients often present with severe comorbidities, particularly ischemic heart disease.
- Managing these complex cases requires careful consideration of surgical approach and patient risk.
Purpose of the Study:
- To evaluate the outcomes of surgical management for gastric cancer in patients with severe concomitant cardiovascular diseases.
- To compare the safety and efficacy of simultaneous versus stepwise surgical treatments.
Main Methods:
- Retrospective analysis of 51 gastric cancer patients with severe cardiovascular disease (ischemic heart disease, valvular heart disease, carotid artery stenosis, aortic aneurysm) operated on between 1995-2011.
- Data collected included patient demographics, cancer stage, surgical approach (simultaneous vs. stepwise), complications, and mortality.
- Surgical procedures included radical tumor resection (72.5%) and palliative operations (25.5%).
Main Results:
- Overall complication rate was 47.1%, with a mortality of 5.9%.
- Simultaneous operations on the stomach and vessels demonstrated a 55.6% complication rate but zero lethality.
- Stepwise treatment resulted in a 45.2% complication rate and 7.1% lethality.
Conclusions:
- While stepwise treatment showed a lower complication rate, simultaneous surgery offered a survival advantage in this high-risk cohort.
- Surgical strategy for gastric cancer in patients with severe cardiovascular disease should be individualized, balancing risks and benefits.
Abstract:
51 patients with gastric cancer and severe concomitant ischemic heart disease (90.2%), valvular heart disease (5.9%), critical stenosis of the internal carotid artery (2%) or abdominal aortic aneurism (2%) were operated on during 1995-2011yy. Of them men were 41, women - 10; mean age was 65.1 years (51-82). The first stage of gastric cancer was diagnosed in 18 (35.3%) of patients, second, third and fourth in 12 (23.5%), 17 (33.3%) and 4 (7.8%), respectively. Radical tumor resection was achieved in 37 (72.5%), palliative operations were performed in 13 (25.5%) patients. 17.6% of patients were operated on stomach and vessels simultaneously. 82.4% received the stepwise treatment. Intra- and postoperative complications were registered in 47.1% (24 of 51 patients); of whom 5.9% (3 patients) ended lethally. Simultaneous operations showed the 55.6% complications and zero lethality rate, whereas stepwise treatment resulted in 45.2% complications and 7.1% lethality.
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