RESUMO
INTRODUCTION: Multivisceral resection (MVR) is potentially curative for selected gastric cancer patients, supposedly at the cost of increased complications. However, current data comparing MVR to standard gastrectomy (SG) is lacking. OBJECTIVES: Compare complications and survival after MVR and SG. METHODS: In a retrospective cohort of 1015 patients with gastric adenocarcinoma, 58 underwent MVR and 466 SG. Groups were compared concerning their characteristics, complications, and survival. RESULTS: One hundred seventy-six patients had postoperative complications. Major complications were more frequent after MVR (P = .002). Surgical mortality was 8.6% and 4.9% for MVR and SG (P = .221). Older age, higher morbidities, and MVR were independent risk factors for major complications. The odds ratio for major complications was 5.89 for MVR with one or two organs and 38.01 for MVR with three or more organs. The pancreas was the most commonly removed organ and pT4b disease were confirmed in 34 (58.6%) of the MVR cases. Disease-free survival (DFS) was lower in MVR patients (51% vs 77.8%; P < .001), being worse according to the number of organs resected. In pN+ patients, DFS was worse after MVR. DFS was equivalent to pT4b and non-pT4b in the MVR group. CONCLUSIONS: Increased morbidity and lower survival are expected for gastric cancer patients undergoing MVR.
Assuntos
Gastrectomia , Neoplasias Gástricas/terapia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Fatores Etários , Quimioterapia Adjuvante , Estudos de Coortes , Colo/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Multimorbidade , Terapia Neoadjuvante , Pâncreas/cirurgia , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco , Esplenectomia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologiaAssuntos
Procedimentos Cirúrgicos do Sistema Digestório , Acalasia Esofágica , Refluxo Gastroesofágico , Miotomia , Humanos , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Fundoplicatura , Resultado do Tratamento , Esfíncter Esofágico Inferior/cirurgia , Acalasia Esofágica/cirurgiaRESUMO
Gastrointestinal perforation by fishbone causing a liver abscess is a rare entity, but should be included in the differential diagnosis to avoid delay in the treatment.