Outcome after emergency surgery in patients with a free perforation caused by gastric cancer

Tsujimoto,Hironori; Hiraki,Shuichi; Sakamoto,Naoko; Yaguchi,Yoshihisa; Horio,Takuya; Kumano,Isao; Akase,Takayoshi; Sugasawa,Hidekazu; Aiko,Satoshi; Ono,Satoshi; Ichikura,Takashi; Kazuo,Hase

doi:10.3892/etm_00000032

January-February 2010 Volume 1 Issue 1

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January-February 2010 Volume 1 Issue 1

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Article

Outcome after emergency surgery in patients with a free perforation caused by gastric cancer

Authors:
- Hironori Tsujimoto
- Shuichi Hiraki
- Naoko Sakamoto
- Yoshihisa Yaguchi
- Takuya Horio
- Isao Kumano
- Takayoshi Akase
- Hidekazu Sugasawa
- Satoshi Aiko
- Satoshi Ono
- Takashi Ichikura
- Hase Kazuo
View Affiliations / Copyright

Affiliations: Department of Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan. tsujihi@ndmc.ac.jp
Pages: 199-203
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Published online on: January 1, 2010

https://doi.org/10.3892/etm_00000032
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Abstract

Perforation of gastric cancer is rare and it accounts for less than 1% of the incidences of an acute abdomen. In this study, we reviewed cases of benign or malignant gastric perforation in terms of the accuracy of diagnosis and investigated the clinical outcome after emergency surgery in patients with a free perforation caused by gastric cancer. On the basis of pathological examination, gastric cancer was diagnosed in 8 patients and benign ulcer perforation in 32 patients. The sensitivity, specificity and accuracy of intraoperative diagnosis by pathological examination were 50, 93.8 and 85%, respectively. Except for age, there were no differences in the other demographic characteristics between patients with gastric cancer and benign ulcer perforation. The median survival time of patients with perforated gastric cancer was 195 days after surgery. Patients with gastric cancer perforation had a poorer overall survival rate than those who had T3 tumors without perforation. In addition, in patients with perforation, recurrence of peritoneum occurred more frequently. In conclusion, to improve the survival rate of patients with perforated gastric cancer and to improve the accuracy of intraoperative diagnosis, endoscopic examination and/or pathological examination of the frozen section should be performed, if possible. A balanced surgical strategy using laparoscopic local repair as the first-step of surgery, followed by radical open gastrectomy with lymphadenectomy may be considered.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Outcome after emergency surgery in patients with a free perforation caused by gastric cancer

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