Surgical treatment of gastric cancer concurrent with portal hypertension
10.3760/cma.j.issn.1007-631X.2011.05.008
- VernacularTitle:胃癌合并门静脉高压症的手术治疗选择
- Author:
Xiangyu WANG
;
Lijun LI
;
Zhouxiang JIN
;
Weimin LU
;
Hongfei TONG
;
Zhiqiang ZHENG
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Hypertension,portal;
Degestive system surgical procedures
- From:
Chinese Journal of General Surgery
2011;26(5):384-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the surgical approaches for gastric carcinoma accompanied by portal hypertension ( PHT).Methods The clinical data of 22 patients with PHT undergoing operation during 5 years were retrospectively analyzed.The liver function was Child's A in 12 cases, Child's B in 10 cases.Total gastrectomy + pericardial devascularization was performed in 11 cases, distal subtotal gastrectomy in 9 cases, distal subtotal gastrectomy + splenectomy in one, distal subtotal gastrectomy + pericardial devascularization in one.12 cases with Child's A underwent D2 lymph node (LN) dissection and 10 cases with Child's B were treated with D1 LN dissection.Liver biopsy was taken in all patients.Results Postoperative complications developed in 50% and mortality rate was 9%.The rate of liver function deterioration in patients of Child A ungergoing D2 lymph node dissection was 42% , and that of patients with Child B was 70%.The rate of postoperatiave complications in patients with Child A ungergoing D2 lymph node dissection was 25% , while that of patients with Child B was 80%.There was no significant difference in liver function deterioration rate between Child A and Child B (P ＞ 0.05) , but the rate of postoperative complications in Child A is much lower than those in Child B(P ＜ 0.05).The complication rate in patients receiving PHT targeting measures was 77% ,much higher than 11% in those without concurrent treatment of PHT ( P ＜ 0.05 ).Conclusions Individualized surgical approache is crucial for treatment of gastric carcinoma accompanied by PHT.Surgical treatment should be on the basis of liver function and the severity of PHT.
