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Objective:To investigate whether elderly patients over 70 years of age with gastric stump carcinoma should be treated with operation and which surgical approaches should be selected.Methods:A retrospective analysis was performed on 36 patients with gastric stump carcinoma without any significant surgical contraindications hospitalized in lanzhou general hospital of lanzhou military area from January 2001 to January 2013.All these patients were over 70 years of age,with an active score of 0-3.The patients were divided into surgical and non-surgical treatment groups,and the surgical treatment group was further subdivided into radical surgery group and palliative surgery group.The treatment modalities,complications and survival of each group were analyzed.Results:A one-year and a three-year survival rate of surgical treatment group was 45.5％ and 22.7％,respectively,whereas the one-year and three-year survival rate of non-surgical treatment group was only 18.2％ and 0％,the difference was statistically significant (P ＜ 0.05).In the surgical treatment group,the radical surgery subgroup had a better survival rate than palliative surgery subgroup,with a one-year and a three-year survival rate of 58.3％ and 33.3％ respectively for the former,and 30％ and 10％ for the latter.The incidence of complications of radical surgery group and palliative surgery group was of no significant difference (P ＞ 0.05).Conclusions:Elderly patients over 70 years of age with gastric stump carcinoma can still benefit from radical surgery;while palliative surgery does not improve the survival rate of the patients,radical surgery is appropriate for elderly patients with gastric stump carcinoma.
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Objective: To evaluate the short-term efficacy of R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma. Methods:Data on 10 patients with gas-tric stump cancer were analyzed retrospectively from January 2013 to August 2014. All the patients received R-type jejunal interposi-tion and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma (laparoscope group) in the Lanzhou General Hospital of the Lanzhou Military Area. Laparotomy was performed on 18 cases that com-prised the control group (laparotomy group). The intraoperative and postoperative indicators between these two groups were then com-pared. All the patients were followed-up from 14 to 21 months after the operations. Results:The operations were successfully carried out in all 10 patients (laparoscope group), without performing open operation. The mean operative times, volumes of the intraoperative blood loss, numbers of dissected lymph nodes, frequencies of leaving the bed, days marking the first liquid diet intake, days marking the recovery of gastrointestinal function, and days of hospitalization of the laparoscope group and the laparotomy group were (210.0 ± 30.9) min and (283.9 ± 50.9) min, (90.0 ± 26.7) mL and (277.8 ± 79.1) mL, (19.0 ± 3.6) and (18.8 ± 3.7), (17.3 ± 3.6) h and (75.8 ± 15.7) h, (1.6 ± 0.4) d and (5.7 ± 1.3) d, (3.0 ± 0.8) d and (7.2 ± 1.3) d, and (7.6 ± 1.2) d and (20.8 ± 3.9) d, respectively. Anastomotic stricture, reflux esophagitis, bleeding, leakage, dumping syndrome, or intestinal obstruction was not detected in the laparoscope group. There was no perioperative death. All of the cases exhibited good nutrition situation, and no choking or esophagus burning was reported. Conclusion:R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy is safe and feasible. The operation can improve the quality of life of patients and induce positive short-term therapeutic effects. Laparo-scopic-assisted radical gastrectomy for gastric stump cancer has the same effect as laparotomy.
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Objective To analyze surgical diagnosis and treatment effect of 25 cases with gastric stump carcinoma.Methods The clinical manifestations and therapies of 25 cases with gastric stump carcinoma in our hospital from 1992 to 2003 were analyzed retrospectively.We sum up the surgical methods and postoperative survival rate.Results The postoperative survival rates of 1,3 and 5 years in 25 cases with gastric stump carcinoma were 60.2%,34.2% and 18.6% respectively,and were 81.4%,48.2% and 36.7% respectively in cases treated with radical resection.Conclusion No specific symptoms were identified,endoscopy examination periodically is the key point to detect gastric stump carcinoma.Radical resection is the most effective surgical style for surgical treatment of gastric stump carcinoma.
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Objective To analyze the surgical operation and prognosis of gastric stump carcinoma in elderly patients. Methods The clinical data of 25 cases of elderly gastric stump carcinoma in our department from 1993 to 2003 were analyzed retrospectively. Results In this group of cases, TNM stages Ⅰ, Ⅱ, Ⅲ and Ⅳ was 3, 5, 8 and 7 cases, respectively. Among them, radical resection was performed in 12 cases(48.0%), palliative operation in 9 cases(36.0%), exploratory laparotomy in 2 cases, and 2 cases lost the chance of resection due to extensive tumor dissemination. Nutritional jejunostomy was performed in all the cases received resection operation. 1, 3 and 5 years survival rates in the patients who underwent radical dissection were 81.2%, 41.5% and 28.6%, respectively. Conclusion Endoscopy examination plus gastric mucosa biopsy were major means for diagnosis of gastric stump carcinoma in elderly patients. Perioperative managements should be emphasized. Radical resection was a reasonable therapeutic procedure of elderly gastric stump cancer, and was also an important factor affecting prognosis.