Multivisceral surgery in advanced gastric carcinoma

From April 1986 to June 1994 a total of 284 patients with gastric carcinoma were admitted to the authors' department. Mainly advanced tumour stages were seen: stage I = = 23%, II = 13%, III = 22% and IV = 42%. In 256 tumour resections (resection rate = 90%) multivisceral surgery (mvs) was necessary in 146 patients (mvs = 57%). Long-term survival of stage IV gastric cancer patients cannot be prolonged by mvs, and RD-resection can be achieved in few patients (9/120 = 7.5% in stage IV). Perioperative morbidity, postoperative complications and the mean postoperative hospital stay were increased after extensive surgery. Major complications were anastomotic leakage, local infections and pulmonary diseases. Even when resection seems to be an acceptable palliation for stage IV gastric cancer patients, mvs in only justified where RD-resection seems achievable.