Il ruolo della chirurgia
Archives of Surgery 2008 Aug;143(8):769-75; discussion 775.
Four hundred consecutive total gastrectomies for gastric cancer: a single-institution experience.
Pacelli F, Papa V, Rosa F, Tortorelli AP, Sanchez AM, Covino M, Bossola M, Doglietto GB. Digestive Surgery Unit, Department of Surgery, Catholic University School of Medicine, 8 Largo A. Gemelli, 00168 Rome, Italy. email@example.com
HYPOTHESIS: Although total gastrectomy (TG) has been generally accepted as the treatment of choice for upper and middle gastric cancers, some issues are still debated. The objective of this retrospective study was to analyze short- and long-term results of TG (radical and palliative) in a series of 400 patients consecutively admitted to our surgical unit. DESIGN: Retrospective cohort study. SETTING: Primary and referral hospital care. PATIENTS: Hospital records of 400 patients who consecutively underwent TG between January 1981 and June 2005 were reviewed. MAIN OUTCOME MEASURES: Surgical complications and survival. RESULTS: Three hundred twelve patients underwent radical procedures, and 88 patients underwent palliative procedures. The incidence of postoperative complications was higher among patients who underwent palliative TG (33 of 88 [37.5%]) compared with patients who underwent curative TG (75 of 312 [24.0%]) (P =.01). Mortality was higher among patients who underwent palliative TG (6 of 88 [6.8%]) compared with patients who underwent curative TG (11 of 312 [3.5%]) (P =.18). Five-year survival was 61.8% after curative TG and 12.8% after palliative TG. Ten-year survival was 47.3% after curative TG and 0.0% after palliative TG. CONCLUSIONS: This study among 400 consecutive patients who underwent TG at the same surgical unit shows that this surgical procedure in experienced hands can lead to excellent short- and long-term results.