KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ UNG THƯ BIỂU MÔ DẠ DÀY 1/3 DƯỚI TẠI BỆNH VIỆN ĐA KHOA TỈNH THÁI BÌNH

Abstract

Objectives: To describe clinical, paraclinical characteristics and surgical results of lower third gastric carcinoma at Thai Binh province general hospital. Methods: Including 143 patients with carcinoma of the lower third of the stomach who were surgically treated at Thai Binh Provincial General Hospital from January 1, 2019 to January 1, 2021. Results: Mean age: 64.9 ± 10 (35-89 years old); male/female ratio = 2.18/1; The time from symptom onset to hospital admission was mainly 6-12 months (46.2%), common clinical symptoms: epigastric abdominal pain (74.1%), anorexia and weight loss (55 .6%), vomiting (39.2%), pyloric stenosis (16.1%), asymptomatic (7%); 30.1% had a history of chronic gastric ulcer. Macroscopic images are mainly ulcerative and invasive ulceration (88.1%), wart and infiltrative form 4.9% and 7%, respectively. Histopathology: moderately differentiated adenocarcinoma (44.7%), poorly differentiated adenocarcinoma (30.9%), highly differentiated adenocarcinoma (5.6%), ring cell carcinoma (13.9%), cancer of the mucous gland (4.9%). Most tumor invasion was T4 (45.5%), T1, T2 (30.1%); 60.1% of patients had lymph node metastasis, the average number of removed lymph nodes was 11.57 ± 4.8; the average number of metastatic lymph nodes was 3.71 ± 4.5 lymph nodes. In terms of surgical results, time to have a bowel movement: 3.85 ± 0.84 days, time to drain: 7.1 ± 1.3 days, hospital stay: 9.6 ± 2.1 days; Post-operative complications were 8.4%, of which the most common were pneumonia 2.8%, wound infection 2.8%, postoperative bleeding 1.4%, anastomosis and incisional tear 0.7. %. 3 patients having surgery again accounted for 2.1%, 2 cases of postoperative bleeding and 1 case of incision; 97.9% of stable patients were discharged, 2.1% of patients died or seriously transferred to hospital. Overall survival was 40 ± 1.5 months, disease-free survival time was 38.8 ± 1.6 months. Conclusion: Lower third gastric carcinoma occurs at different ages, moderate progression, histopathology is usually medium-differentiated adenocarcinoma, usually in the locally invasive stage, the rate is low. high rate of lymph node metastasis. Surgical treatment of carcinoma of the lower third of the stomach is relatively safe, feasible and has few complications.