Author(s): Rajesh T. R1, Freena Rose2
BACKGROUND Stomach cancer is the fourth most common malignancy in the world.1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0) is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to find- a) The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO) in patients undergoing gastrectomy for distal gastric cancer. b) To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c) To see if the histology of the tumour has any role in the development of GOO.
MATERIALS AND METHODS
This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015.
Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant). Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005). Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%).
(a). Operability rate of distal gastric cancer in our institution is 45.8%. (b). Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c). Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%). (d). Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e). Both intestinal and diffuse histology have equal incidence of GOO. (f). Chronic blood loss and incidence of anaemia is more in intestinal type of tumours compared to diffuse histology.
Gastric Outlet Obstruction, GOO, Cancer Stomach, Intestinal Histology.