OBJECTIVE： To determine the value of resection of combined visceral organs in surgical treatment of gastric cardiac carcinoma. METHODS： We retrospectively analyzed 217 random patients with carcinoma of the gastric c...OBJECTIVE： To determine the value of resection of combined visceral organs in surgical treatment of gastric cardiac carcinoma. METHODS： We retrospectively analyzed 217 random patients with carcinoma of the gastric cardia who underwent a gastric cardiac resection. The patients had been treated as follows： 186 with partial gastrectomy, 31 with total gastrectomy, 97 with a combined-visceral resection, of which 82 underwent a splenectomy plus partial pancreatectomy, 10 with splenectomy alone and 5 with partial hepatectomy and diaphragmatectomy. RESULTS： The total patients were divided into 3 groups： 128 with a gastrectomy alone, 10 with gastrectomy and splenectomy, and 82 with gastrectomy and splenectomy plus pancreatectomy. The operating times for these 3 groups were respectively 3.0 h, 3.1 h and 3.8 h. The hospitalization times were respectively 23.8 d, 31.2 d and 25.9 d. No differences in post-operative complications were found between these 3 groups. There were 92 patients who underwent a gastrectomy combined with a splenectomy and （or） the pancreatectomy, in which 92 No.10 lymph nodes were eliminated, with an average of one in each patient. Among the 125 patients not receiving a splenectomy but with elimination of lymph nodes, 82 underwent a gastrectomy combined with partial pancreatectomy, of which 107 lymph nodes were eliminated for the No. 11 group, with an average of 1.3 in each patient. There was a statistically significant difference between the 2 groups. The overall survival rates were similar in the 3 groups showing no statistical differences, but was higher in the Stage Ⅲ patients with a combined resection of multi-organs. For patients in the Stage Ⅳ without resection of multi-organs, the survival rate was higher, but there was no significant difference between the 2 groups. CONCLUSION： It is difficult to determine precisely the involvement of para-tumorous organs with the eye during an operation. Combining a splenectomy with a pancreatectomy does not increase the post-operative complications following surgical treatment for carcinoma of the gastric cardia. The combination of a splenectomy and partial pancreatectomy results in a higher survival rate and has an important significance for eliminating the lymph nodes of group 10 and 11, especially for patients in Stage Ⅲ. In the application of a resection combining multi-organs, the doctor should make every effort to decrease the trauma and the complications based on the condition that the cancerous tissue is totally resected.展开更多
文摘OBJECTIVE： To determine the value of resection of combined visceral organs in surgical treatment of gastric cardiac carcinoma. METHODS： We retrospectively analyzed 217 random patients with carcinoma of the gastric cardia who underwent a gastric cardiac resection. The patients had been treated as follows： 186 with partial gastrectomy, 31 with total gastrectomy, 97 with a combined-visceral resection, of which 82 underwent a splenectomy plus partial pancreatectomy, 10 with splenectomy alone and 5 with partial hepatectomy and diaphragmatectomy. RESULTS： The total patients were divided into 3 groups： 128 with a gastrectomy alone, 10 with gastrectomy and splenectomy, and 82 with gastrectomy and splenectomy plus pancreatectomy. The operating times for these 3 groups were respectively 3.0 h, 3.1 h and 3.8 h. The hospitalization times were respectively 23.8 d, 31.2 d and 25.9 d. No differences in post-operative complications were found between these 3 groups. There were 92 patients who underwent a gastrectomy combined with a splenectomy and （or） the pancreatectomy, in which 92 No.10 lymph nodes were eliminated, with an average of one in each patient. Among the 125 patients not receiving a splenectomy but with elimination of lymph nodes, 82 underwent a gastrectomy combined with partial pancreatectomy, of which 107 lymph nodes were eliminated for the No. 11 group, with an average of 1.3 in each patient. There was a statistically significant difference between the 2 groups. The overall survival rates were similar in the 3 groups showing no statistical differences, but was higher in the Stage Ⅲ patients with a combined resection of multi-organs. For patients in the Stage Ⅳ without resection of multi-organs, the survival rate was higher, but there was no significant difference between the 2 groups. CONCLUSION： It is difficult to determine precisely the involvement of para-tumorous organs with the eye during an operation. Combining a splenectomy with a pancreatectomy does not increase the post-operative complications following surgical treatment for carcinoma of the gastric cardia. The combination of a splenectomy and partial pancreatectomy results in a higher survival rate and has an important significance for eliminating the lymph nodes of group 10 and 11, especially for patients in Stage Ⅲ. In the application of a resection combining multi-organs, the doctor should make every effort to decrease the trauma and the complications based on the condition that the cancerous tissue is totally resected.
