Subject(s)
Burns, Chemical/complications , Colon/transplantation , Esophageal Stenosis , Esophagoplasty , Plastic Surgery Procedures/methods , Postoperative Complications , Tracheal Stenosis , Tracheostomy , Aged , Esophageal Stenosis/chemically induced , Esophageal Stenosis/diagnosis , Esophageal Stenosis/physiopathology , Esophageal Stenosis/surgery , Esophagoplasty/adverse effects , Esophagoplasty/methods , Esophagus/diagnostic imaging , Esophagus/surgery , Female , Humans , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Radiography/methods , Reoperation/methods , Trachea/diagnostic imaging , Trachea/surgery , Tracheal Stenosis/chemically induced , Tracheal Stenosis/diagnosis , Tracheal Stenosis/physiopathology , Tracheal Stenosis/surgery , Tracheostomy/adverse effects , Tracheostomy/methods , Treatment OutcomeABSTRACT
Results of surgical treatment of 170 patients with early cancer of the stomach are analyzed. There were 113 patients with tumor invasion within the bounds of the mucous membrane (m -- 113), the others had invasion within the bounds of the submucous membrane (sm -- 57 patients). Impressed and ulcered macroscopic types of early cancer (IIc + III) were diagnosed most often: 57% m+sm (97 of 170), 58.4% m+sm (97 of 170), 54.4% sm (31 of 57), respectively. Poorly differentiated tumors prevailed over moderate- and well-differentiated tumors - 68.8% (117 of 170) and 31.2 (53 of 170) patients, respectively. Subtotal distal resection of the stomach has been performed in 118 (69,4%) patients, subtotal proximal resection -- in 13 (7.7%), gastrectomy -- in 22 (12.9%), resection of 2/3 stomach -- in 14 (8.2%), resection of the cardia - in 3 (1,8%). Lymphadenectomy has been performed in 156 patients including 1 (0.6%) patient with D0-lymphadenectomy, 88 (56.4%) - D1, 62 (39.7%) -- D2, and 5 (3.2%) -- D3. Metastases to the regional lymph nodes have been revealed in 8 (5%) cases -- 2 m and 6 sm. Extended lymphodissections (D2 and D3) have improved significantly long-term results. Five-year survival among the patients who had undergone extended operations with D2 and D3 lymphadenectomies was higher compared with patients after limited and standard operations (D0 and D1) -- 96.0+/-2.5 and 87.0+/-3.5%, respectively.
Subject(s)
Early Diagnosis , Stomach Neoplasms/pathology , Adult , Age Factors , Aged , Female , Gastroscopy , Humans , Male , Middle Aged , Retrospective Studies , Stomach Neoplasms/epidemiology , Stomach Neoplasms/therapyABSTRACT
Results of radical surgical treatment of 86 patients with early cancer of the stomach are analyzed. Among revealed macroscopic types of early cancer of the stomach (B0), type I (elevated) was seen in 26 (31%) patients, type IIa (superficial raised) - in 8 (9%), type IIb (superficial plane) - in 7 (8%), type IIc (superficial excavated) - in 20 (23%), type III (ulcerated) - in 25 (29%) patients. Adenocarcinoma was the prevalent tumor - 84 (98%) patients, in 1 (1%) case undifferentiated cancer was revealed and in 1 (1%) - carcinoid tumor. Tumor invasion was limited by mucosa in 49 (57%) patients, in submucosa - in 37 (43%). Metastases to lymph nodes were diagnosed in 4 (5%) patients. Subtotal proximal resection performed in 6 patients, subtotal distal resection - in 60, gastrectomy - in 20 patients. Lymphadenectomy corresponded to D1 in 30 cases, to D2 - in 51, to D3 - in 5 cases. Complications after surgery were seen in 21 (24%) patients. Cancer in the gastric stump was diagnosed in 3 (4%) patients 2, 4 and 6 years after primary subtotal distal resection of the stomach with D1 lymphadenectomy. All these patients underwent extirpation of gastric stump. Radical surgery for early cancer of the stomach must include extended lymphadenectomy D2 or more.
