Berrospi F, Ruiz E, Morante C, Celis J, Montalbelti J A
Instituto de Enfermedades Neoplásicas, Lima-Perú.
Rev Gastroenterol Peru. 1995 Jan-Apr;15(1):43-8.
Determination of the postoperative morbidity and mortality after gastroenterostomy in patients with unresectable gastric cancer.
Retrospective review of clinical records of all patients with obstructive distal gastric cancer who underwent gastroenterostomy at the Instituto de Enfermedades Neoplásicas between 1980 and 1993. The following factors were analyzed: age, sex, hemoglobin, albumin, preoperative risk, ascites, extent of disease, operative time, hospital stay, morbidity and mortality.
198 gastroenterostomy were done with a morbidity and mortality rates of 20% and 10%, respectively. Pneumonia was the principal cause of postoperative morbidity and mortality. High operative risk, adjacent organ invasion by the tumor and peritoneal metastasis were factors associated with increased postoperative morbidity (p > 0.05). High operative risk was the only prognostic factor for postoperative mortality (p < 0.01).
Because of high postoperative morbidity and mortality, gastroenterostomy should not be done in patients with unresectable gastric cancer and high preoperative risk.
确定不可切除胃癌患者胃肠造口术后的发病率和死亡率。
回顾性分析1980年至1993年间在肿瘤疾病研究所接受胃肠造口术的所有梗阻性远端胃癌患者的临床记录。分析了以下因素:年龄、性别、血红蛋白、白蛋白、术前风险、腹水、疾病范围、手术时间、住院时间、发病率和死亡率。
共进行了198例胃肠造口术,发病率和死亡率分别为20%和10%。肺炎是术后发病和死亡的主要原因。高手术风险、肿瘤侵犯相邻器官和腹膜转移是与术后发病率增加相关的因素(p>0.05)。高手术风险是术后死亡的唯一预后因素(p<0.01)。
由于术后发病率和死亡率较高,不可切除胃癌且术前风险高的患者不应进行胃肠造口术。