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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer
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Hemorrhagic Complications in Gastric Cancer: Current Evidence and Multidisciplinary Management Strategies
Sang-Ho Jeong1, Miyeong Park2, Kyung Won Seo3
1Department of Surgery, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Republic of Korea.
Cancers
|August 13, 2026
Summary
Gastric cancer bleeding is a serious emergency. A multidisciplinary approach using endoscopy, embolization, radiotherapy, and surgery, followed by chemotherapy, improves outcomes.
Area of Science:
- Oncology
- Gastroenterology
- Interventional Radiology
Background:
- Hemorrhage is a critical emergency in gastric cancer, affecting 3-36% of patients.
- Bleeding can become life-threatening rapidly, necessitating timely intervention.
- Management strategies require integration across multiple medical specialties.
Purpose of the Study:
- To propose a multidisciplinary, stepwise framework for managing gastric cancer-associated bleeding.
- To synthesize evidence from the past two decades on bleeding management.
- To emphasize hemostasis as a bridge to definitive anticancer therapy.
Main Methods:
- Review of evidence from the past two decades.
- Proposal of a stepwise management framework.
- Integration of data on endoscopic hemostasis, transcatheter arterial embolization, palliative radiotherapy, and surgery.
Main Results:
- Endoscopic hemostasis is first-line (83-92.9% initial control), with 28-41% rebleeding.
- Transcatheter arterial embolization shows ~72% success for persistent bleeding.
- Palliative radiotherapy achieves 68-88.5% hemostasis; surgery is individualized.
- Hemostasis followed by chemotherapy improves overall survival.
Conclusions:
- A coordinated, multidisciplinary approach is crucial for managing gastric cancer bleeding.
- Hemostasis serves as a bridge to definitive oncologic treatment.
- Integrated care involving gastroenterology, interventional radiology, surgery, and oncology optimizes patient outcomes.
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