Acta Medica Medianae
Institut za digestivne bolesti, Klinika za gastroenterohepatologiju Kliničkog centra
Admirala Geprata br.7, 11000 Beograd
Copyright 2008 by Faculty of Medicine, University of Nis
THE EFFECT OF ENDOSCOPIC AND INTRAOPERATIVE RESULTS ON THE TYPE AND EXTENSIVENESS OF STOMACH CANCER OPERATION
Aleksandra Z Krstic
Gastroscopy is the main method for diagnosing malignant disease of the stomach.
The aim of the paper was to prove that endoscopic results, together with intraoperative finding, determine the type and extensiveness of the cancer operation.
The paper included 70 patients, all of them with the diagnosis of cancer or adenocarcenoma of the stomach, using the method of gastroscopy and pathohistological (PH) verification. Of this number, 38 patients underwent radical operation (total or subtotal gastrectomy) with systemic lymphadenectonomy; 15 patients underwent palliative operation for improving the quality of life; 15 patients underwent explorative laparatomy for making the final diagnosis and possible palliative operation; 2 patients died due to poor general medical condition of the organism after making the endoscopic and pathohistological diagnosis. The obtained data data were processed and presented in tables and charts. In all applied analytical methods, the level of significance was 0,05.
The treatment outcome did not depend on the localization (regio antri et pylori, regio cardiae, regio pangastrica, regio corporisi) and macroscopic finding of the tumor (ulceroinfiltrative, diffuse infiltrative, ulcerative, fungoid form). Worse TNM status, worse P and H classification in the patients before the applied therapy significantly influenced the survival rate. Similar findings were also comfirmed for the definitive TNM status, P and H classification. The treatment outcome was significantly influenced by the pH finding, as intestinal type of cancer prevailed in the deceased. Prognostically, the presence of metastases had the worst influence on the course and outcome of the treatment.
Early diagnosis of stomach cancer is of greatest importance for survival of these patients. Tumor size (T), as well as the pathohistological result (PH) and lymphonodal status (N) significantly influence the operative treatment radicality and distant metastases. By applying radical lymphadenectomy with total and subtotal gastrescomy, survival length increases, which we expect in our patients whose health is constantly being monitored; they are in a good general medical condition, with no signs of recurrences. By applying radical extensive lymphadenectomy, the rate of survival is increased. Acta Medica Medianae 2008;47(3):44-49.
Key words: gastroscopy, edoscopy, carcinoma ventriculi