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首页> 外文期刊>Eastern Journal of Medicine >Perforated Gastr?c Cancer: A D?ff?cult Challenge For The Surgeon.
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Perforated Gastr?c Cancer: A D?ff?cult Challenge For The Surgeon.

机译：穿孔胃癌：外科医生的艰巨挑战。

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Perforated Gastr?c Cancer: A D?ff?cult Challenge For The Surgeon. ?zkan y?lmaz , Necat Almal? Department Of General Surgery, Faculty Of Medicine, Yuzuncu Yil University, Van, Turkey INTRODUCTION: Perforated gastric cancer (PGC) is a rare complication of gastric cancer that is associated with high in-hospital mortality. Most patients with PGC undergo emergency surgery with a prediagnosis of acute abdomen. The challenges faced in the preoperative diagnosis persist during surgery due to lack of an optimum surgical approach, meaning that the surgical treatment of patients with PGC is often based on the experience and prejudices of the surgeon. The aim in the present study is to evaluate the clinicopathological characteristics of patients with PGC and to discuss the currently available surgical treatment options. METHODS: The present study investigated retrospectively the demographic characteristics of 30 patients who underwent surgery for pgc in our clinic, and in whom a pathological examination revealed adenocarcinoma. The study further evaluated the relationship between the employed treatment methods and survival. RESULTS: The study included 30 patients, 23 of which were male and seven who were female. The mean age was 62.4±10.5 years. In terms of disease progression, 23 patients had stage IV, six had stage III and one had stage II. Of the total, 19 patients underwent a gastrectomy and 11 underwent local repair. In-hospital mortality occurred in 10 patients (four of which underwent a gastrectomy and six who underwent a local repair). The difference between the gastrectomy and local repair groups was significant in terms of mortality (p0.017). Overall survival was 286±516.7 days across the entire study group, 421.2±614.8 days in the gastrectomy group and 68±105.7 days in the local repair group. There was a significant difference between the two groups in terms of mean survival (p0.13). A positive correlation was identified between perioperative sepsis parameters and in-hospital mortality. The mean survival time was significantly higher in the non-septic group (886±729.5 days) than in the septic group (67.8±65.5 days) (p0.01). DISCUSSION AND CONCLUSION: Patients with PGC represent a challenge for surgeons due to difficulties in treatment and the poor prognosis of the patients. Although PGC occurs in only very rare occasions, it must be kept in mind that the selection of an appropriate surgical therapy and the successful treatment of sepsis are of vital importance.
机译：穿孔胃癌：外科医生的艰巨挑战。 zkan y？lmaz，内卡特·阿尔玛？土耳其范·尤祖库伊尔大学医学院普通外科系简介：穿孔胃癌（PGC）是一种罕见的胃癌并发症，与高院内死亡率相关。大多数PGC患者接受急诊手术，并有急性腹部的预诊断。由于缺乏最佳的手术方法，术前诊断面临的挑战仍然存在，这意味着PGC患者的手术治疗通常基于外科医生的经验和偏见。本研究的目的是评估PGC患者的临床病理特征并讨论当前可用的外科治疗方案。方法：本研究回顾性研究了在我们诊所接受pgc手术的30例患者的人口统计学特征，其中病理检查显示为腺癌。该研究进一步评估了所采用的治疗方法与生存率之间的关系。结果：该研究包括30例患者，其中23例为男性，七例为女性。平均年龄为62.4±10.5岁。在疾病进展方面，有23例患者进入IV期，6例进入III期，1例进入II期。在全部患者中，有19例接受了胃切除术，而11例接受了局部修复。 10例患者发生院内死亡（其中4例接受了胃切除术，6例接受了局部修复）。就死亡率而言，胃切除术组与局部修复组之间的差异显着（p <0.017）。整个研究组的总生存期为286±516.7天，胃切除术组为421.2±614.8天，局部修复组为68±105.7天。两组之间在平均生存率方面存在显着差异（p <0.13）。围手术期脓毒症参数与住院死亡率之间存在正相关。非感染组（886±729.5天）的平均生存时间显着高于感染组（67.8±65.5天）（p <0.01）。讨论与结论：由于治疗困难和患者预后不良，PGC患者对外科医师构成了挑战。尽管PGC仅在极少数情况下发生，但必须记住，选择合适的手术疗法和成功治疗败血症至关重要。

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