Surgical Results for Perforated Gastric Cancer

천공성 위암의 수술 방법과 치료 결과

  • Lee, Moon-Soo (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Chae, Man-Kyu (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Tae-Yun (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Cho, Gyu-Seok (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Sung-Yong (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Baek-Moo-Jun (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Chung-Il-Kwon (Departments of Internal Medicine, College of Medicine, Soonchunhyang University) ;
  • Park, Kyung-Kyu (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Chang-Ho (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Song-Ok-Pyung (Departments of Surgery, College of Medicine, Soonchunhyang University) ;
  • Cho, Moo-Sik (Departments of Surgery, College of Medicine, Soonchunhyang University)
  • 이문수 (순천향대학교 천안병원 외과학교실) ;
  • 채만규 (순천향대학교 천안병원 외과학교실) ;
  • 김태윤 (순천향대학교 천안병원 외과학교실) ;
  • 조규석 (순천향대학교 천안병원 외과학교실) ;
  • 김성용 (순천향대학교 천안병원 외과학교실) ;
  • 백무준 (순천향대학교 천안병원 외과학교실) ;
  • 정일권 (순천향대학교 천안병원 내과학교실) ;
  • 박경규 (순천향대학교 천안병원 외과학교실) ;
  • 김창호 (순천향대학교 천안병원 외과학교실) ;
  • 송옥평 (순천향대학교 천안병원 외과학교실) ;
  • 조무식 (순천향대학교 천안병원 외과학교실)
  • Published : 2002.06.01

Abstract

Purpose: Perforated gastric cancer (PGC) is rare and occurs in $1\∼4\%$ of all gastric cancers. Possible dissemination of tumor cells at the time of perforation of the gastric carcinoma has been a matter of concern. The intraoperative determination of what kind of operation should be done and how extensive the lymphnode dissection should be still remains controversial. The purpose of this study is to evaluate the factors influencing the survival and to determine the optimal treatment for PGC. Materials and Methods: A total of 42 patients were operated on for a perforated gastric carcinoma at Soonchunhyang University Chunan Hospital from 1983 to 2000. the age and the sexes of the patients, the location of perforation, the diameter of perforation, the histologic type of the tumor, the depth of wall invasion, the absence or presence of lymph node metastasis / distant metastasis, the stage of disease, the type of operation, and the outcomes were examined. Statistically significant differences were analyzed by using Fisher's exact test. Results: The stage distributions according to the UICC classification were 1 case of stage I, 6 cases of stage II, 17 cases of stage III, and 11 cases of stage IV. An emergency gastrectomy was done in 26 patients ($61.9\%$), with a 5-yr survival rate of $44\%$. The survival of patients was significantly influenced by the depth of wall invasion, the lymphnode metastasis, distant metastasis, the stage of disease, and the type of operation. Conclusions: an emergency gastrectomy is the treatment of choice for most patients with resectable PGC. Choosing more a optimistic surgical approach for potentially curative cases of PGC should be one way to increase the patient's survival rate.

Keywords