Surgery for stage IV gastric cancer

Role of gastric bypass in patients with unresectable advanced carcinoma of stomach

“…There was also no survival difference between those who underwent bypass and those who underwent exploratory laparotomy alone. This is similar to the study by Medina-Franco H, et al [2].…”

“…vomiting due to gastric outlet obstruction (90%) and epigastric mass (39%) were much more common in our study compared to previous reports [2,7]. This was furthur corroborated by the intra op fi nding of infi ltration of adjacent organs in more than half the patients and evidence of abdominal disseminated disease in 32.6% of patients.…”

“…We can therefore conclude that palliation of symptoms is equally good in resection and bypass groups. This is in contrast to the studies done earlier which have shown that resection provides better palliation of symptoms compared to gastroenterostomy [2]. In our study, in-hospital morbidity rate for the entire study group was 19.38% which is similar to the rates obtained in other studies.…”

“…Mean survival time in our study was 10 months for the resection group and six months for the bypass group as against the survival times of 12-18 months for resection in various studies [2,9] and fi ve months for bypass [10]. The lower survival time of the resection group in our study could be because of the more advanced stage of the disease with which our patients presented.…”

“…However, much controversy exists about the role of gastric bypass as a palliative procedure with some studies favouring resection [1,2], and others, bypass [3]. Poor survival rates [2] and high operative morbidity and mortality [4] do not justify bypass in this group of patients.…”