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Gastric cancer surgery in cirrhotic patients: Result of gastrectomy with D2 Iymph node dissection

Authors
 Jun Ho Lee  ;  Junuk Kim  ;  Jae Ho Cheong  ;  Woo Jin Hyung  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.11(30) : 4623-4627, 2005 
Journal Title
WORLD JOURNAL OF GASTROENTEROLOGY
ISSN
 1007-9327 
Issue Date
2005
MeSH
Adult ; Aged ; Female ; Gastrectomy/adverse effects ; Gastrectomy/methods* ; Humans ; Liver Cirrhosis/complications* ; Lymph Node Excision ; Male ; Middle Aged ; Stomach Neoplasms/complications* ; Stomach Neoplasms/surgery*
Keywords
Gastric cancer ; Liver cirrhosis ; D2 lymph node dissection ; Morbidity ; Mortality
Abstract
AIM: To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis. METHODS: A total of 7,178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis. RESULTS: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%) underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P = 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%). CONCLUSION: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contraindication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis.
Files in This Item:
T200500729.pdf Download
DOI
OAK-2005-04214
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Junuk(김준억)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151024
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