ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT CẮT TOÀN BỘ DẠ DÀY DO UNG THƯ BIỂU MÔ TẠI BỆNH VIỆN K

Abstract

Objectives: To describe the clinical, paraclinical characteristics and surgical outcomes of total gastrectomy for gastric adenocarcinoma patients at Quan Su General Surgery Department - K Hospital. Patients and methods: A total 66 gastric cancer patients treated with open total gastrectomy at Quan Su General Surgery Department - K Hospital retrospectively reviewed during the period from 01/2018 - 01/2022. Results: Of 66 patients, the mean age: 60.98 ± 9.87 (39 - 70 years old); male/female ratio = 2.88/1; 91% of patients admitted for epigastric pain; common clinical symptoms: epigastric pain (95.5%), loss of appetite (57.6%), weight loss (27.3%), nausea/vomiting (25.8%); 48.5% of patients had a history of gastric ulcer; the main course of disease was less than 3 months (51.5%). The most common tumor location was the body (50%); histopathology: glandular adenocarcinoma 72.7%, poorly cohesive adenocarcinoma (12.1%), ring cell adenocarcinoma (10.6%), mucinous glandular adenocarcinoma (3%); most had lymphatic invasion (59%) and perineural invasion (59%). The degree of tumor invasion was mostly T4a (50%), T3: 30.3%, T4b: 7.6%, T1b: 4.5%; 59.1% of patients had lymph node metastases, average number of lymph nodes removed: 14.88 ± 8.24. 6% of patients underwent extended total gastrectomy; 100% of patients restored gastrointestinal circulation according to Roux-en-Y; median time: 4.02 ± 0.75 days; median time to drain removal: 8.35 ± 0.94 days; postoperative hospital stay: 11.14 ± 1.51 days; postoperative complications were 15.2%, including pneumonia in 4.6%, no patient underwent reoperation and there was no postoperative mortality; overall median survival time: 46.9 months. Conclusion: Radical surgery for gastric adenocarcinoma by total gastrectomy is safe and can be performed for patients, however, it is necessary to carefully evaluate the stage of the disease, general condition index and accompanying underlying diseases.