Palliative surgery for gastric carcinoma

Abstract

SYNOPSIS This paper presents practical points concerning palliative surgery for carcinoma of the stomach. The results which may be obtained are evaluated.Surgery for carcinoma of the stomach as we know it in Great Britain carries a high operative mortality and a low proportion of lasting cures. Most of the operations are therefore doomed to be no better than palliative. However, the likelihood that symptoms will be alleviated is very good, and palliation may reasonably be hoped to last for a year or two even though the patients are mostly elderly.A palliative operation lengthens the lives of some and shortens those of others, but it relieves the vomiting in most and is without question potentially the most humane treatment. To deserve this description, however, it must avoid the implication that those who succumb shall have to suffer pointlessly in the interval between operation and death, intubated, splinted, dripped, and miserably uncomfortable. It is the doctor who has watched the sometimes disastrous sequelae of ill-planned, illmanaged, would-be surgical palliation who is apt to say, 'I would rather my patients died of their diseases than of their treatments'. The management described here avoids this threat.A distant metastasis which is easily removable does not contraindicate palliative surgery. Indeed, the pathology is not always what it has been taken to be. A huge gastric ulcer in a patient of 77 was thought to be neoplastic, partly because there was a hard nodule at the umbilicus, but this turned out to be a sebaceous cyst. Another old lady who had a palliative total gastrectomy for a leather bottle stomach also had a mass of carcinomatous glands resected from the left axilla. These were found to contain spheroidal-celled growth, and a microscopic second primary was found in the breast at

Cirurgia De Resgate No Câncer Gástrico

“…In contrast, conversion surgery is performed when an initially incurable patient became potentially curable after chemotherapy or chemoradiotherapy. 9 , 17 …”

“…Já a cirurgia de conversão é aquela realizada quando um paciente inicialmente incurável se tornou potencialmente curável após quimioterapia ou radioterapia. 9,17 Atualmente, não há tratamento curativo para o câncer gástrico que não envolva ressecção. 21 Em nossa casuística temos apenas 5% de resposta…”

A comparative study of palliative resections for gastric carcinoma

“…With that in mind it becomes obvious that a certain percentage of potentially curative gastrectomies are in fact palliative. The superiority of gastrectomy over by-pass procedure for incurable gastric cancer has been emphasized in reports by Johnson (1961) and Lawrence et al (1957).…”