The necessity of reinterventions in patients with gastric tumors postoperative complications

Abstract

Introduction: After lung cancer, gastric carcinoma is the most frequent malignant tumor in humankind. We select the surgical treatment according to the location and the extension of the tumor. Radical surgery resection like subtotal gastrectomy and total gastrectomy is performed in early stage tumors, whereas in advanced stages we use palliative treatment to improve quality of life. No matter what therapeutic alternative we choose, the presence of postoperative complications sometimes makes necessary the reintervention, especially when the state of the patient is not improving. Materials and methods: Medical records of 364 patients, 128 women and 236 men who underwent radical surgery and palliative treatment for malignant gastric carcinoma between 01.01.2009 -31.12.2010 at the 3rdSurgical Clinic (Cluj-Napoca, Romania) were retrospectively reviewed. Results: We observed that the most frequent reinterventions were performed in men (241%from the sum of all interventions on both sexes) also patients coming from urban areas (33.9%). Taking into account the symptomatology, those with dyspeptic syndrome presented more often postoperative complications (22.22 %). From the laboratory tests, low hemoglobin and low total proteins give more often postoperative complications and need reinterventions (18.3%) and (16.66%). Most frequent reinterventions were performed and complications appeared after subtotal gastroectomy (17.39%) and associated splenoectomy (26.66%). Liver metastasis (18.18%) and tumor dimension (12.96%) larger than 5 centimeters need reintervention after postoperative complications. Conclusions: In conclusions the malignant gastric carcinoma more frequently observed postoperative complications in men from urban areas, also in patients with dyspeptic syndrome and low hemoglobin and low total proteins. Discussing the surgical treatment, subtotal gastroectomy and associated splenoectomy are the reasons for surgery in case of complications. From the study we can see that liver metastasis and large tumors give complications very often and the necessity of surgery is required.