Abstract
Aim:To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis. Methods: A total of 7 178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis. Results: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%) underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P = 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%). Conclusion: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contra indication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis.
| Original language | English |
|---|---|
| Pages (from-to) | 4623-4627 |
| Number of pages | 5 |
| Journal | World Journal of Gastroenterology |
| Volume | 11 |
| Issue number | 30 |
| DOIs | |
| Publication status | Published - 2005 Aug 14 |
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All Science Journal Classification (ASJC) codes
- Gastroenterology
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Gastric cancer surgery in cirrhotic patients : Result of gastrectomy with D2 lymph node dissection. / Lee, Jun Ho; Kim, Junuk; Cheong, Jae Ho; Hyung, WooJin; Choi, Seung Ho; Noh, Sung Hoon.
In: World Journal of Gastroenterology, Vol. 11, No. 30, 14.08.2005, p. 4623-4627.Research output: Contribution to journal › Article
TY - JOUR
T1 - Gastric cancer surgery in cirrhotic patients
T2 - Result of gastrectomy with D2 lymph node dissection
AU - Lee, Jun Ho
AU - Kim, Junuk
AU - Cheong, Jae Ho
AU - Hyung, WooJin
AU - Choi, Seung Ho
AU - Noh, Sung Hoon
PY - 2005/8/14
Y1 - 2005/8/14
N2 - Aim:To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis. Methods: A total of 7 178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis. Results: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%) underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P = 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%). Conclusion: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contra indication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis.
AB - Aim:To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis. Methods: A total of 7 178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis. Results: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%) underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P = 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%). Conclusion: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contra indication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis.
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U2 - 10.3748/wjg.v11.i30.4623
DO - 10.3748/wjg.v11.i30.4623
M3 - Article
VL - 11
SP - 4623
EP - 4627
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 30
ER -