RESUMEN
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.
Asunto(s)
Gastrectomía , Neoplasias Gástricas/terapia , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Adenocarcinoma/terapia , Factores de Edad , Quimioterapia Adyuvante , Estudios de Cohortes , Colon/cirugía , Supervivencia sin Enfermedad , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Hígado/cirugía , Masculino , Persona de Mediana Edad , Multimorbilidad , Terapia Neoadyuvante , Páncreas/cirugía , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores de Riesgo , Esplenectomía , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patologíaAsunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo , Acalasia del Esófago , Reflujo Gastroesofágico , Miotomía , Humanos , Reflujo Gastroesofágico/etiología , Reflujo Gastroesofágico/cirugía , Fundoplicación , Resultado del Tratamiento , Esfínter Esofágico Inferior/cirugía , Acalasia del Esófago/cirugíaRESUMEN
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.