[Emergency surgery in complicated forms of stomach cancer in middle-aged and elderly patients]

The data on the treatment given to 312 cases of stomach cancer at city district hospitals in Leningrad were evaluated: 243 patients were more than 60 years old, concomittant pathology was apparent in 231 cases, 252 patients were hospitalized to avoid a fatal outcome and 161 patients were urgently operated on for such complications of stomach cancer as bleeding, perforation, peritonitis, and obstruction. Optimal extent of intervention was not determined in some cases due to the extremely poor condition of the patient, insufficient competence of the operating team and inadequate equipment. Radical surgery was performed in 31 cases, palliative resection--11 and other palliative and tentative procedures in 119 cases. The highest postoperative lethality rate (30.9%) was recorded in cases of minimal intervention limited to suturing of vessels and perforations as well as peritoneal cavity draining. Postoperative lethality was reduced to 15.5% and the same conditions whenever radical surgery, palliative resection or interventions eliminating complications by removing the primary cause were carried out. Removal of primary tumor eliminated complications radically, lowered postoperative mortality rates and improved the end results of treatment.