RESUMO
SUBJECT: To determinate the frecuency and the time of development of the gallbladder stones in gastrectomy post-operated patients with stomach adenocarcinoma at The National Cancer Institute in Lima, Peru. METHODS: In an observational, descriptive and retrospective case series design, 148 patiens' files who underwent gastrectomy for stomach adenocarcinoma in the National Cancer Institue of Lima during 1990 and 2000, have been reviewed looking for the development of gallbladder stones. RESULTS: A total de 148 patients were involved in this study. 29 of them (19.6%) develop gallbladder stones during the (x years of) follow up vs 119 (80.9%) . The mean age ot the 29 patients with gallbladder stones were 59.9 years ans 18 of them were female and 11 male.\The mean time of develop gallbladder stones was 3.1 years.According to the type of surgery, 14 patient wiht gallbladder stones underwent to subtotal gastrectomy and 15 to total gastrectomy. CONCLUSIONS: The frecuency of gallbladder stones post gastrectomy in this study was 19.6%. The mean time of the develop and diagnosis of litiasis was 3.1 years.To perform the colecistectomy at the same time of the gastrectomy could be an important decision in patients with high risk of gallstones and gallbladder cancer.We need furthermore studies to have conclusions about the risk factors.
Assuntos
Adenocarcinoma/cirurgia , Colelitíase/epidemiologia , Gastrectomia/métodos , Síndromes Pós-Gastrectomia/epidemiologia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/epidemiologia , Adulto , Idoso , Institutos de Câncer/estatística & dados numéricos , Colecistectomia , Colelitíase/etiologia , Colelitíase/prevenção & controle , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Peru , Síndromes Pós-Gastrectomia/etiologia , Síndromes Pós-Gastrectomia/prevenção & controle , Estudos Retrospectivos , Neoplasias Gástricas/epidemiologiaRESUMO
OBJECTIVE: To evaluate whether the administration of early enteral nutrition in postoperative gastrectomized patients due gastric cancer helps to reduce the frequency of postoperative complications. MATERIALS AND METHODS: A case-control study with 120 patients, 60 with postoperative complications (cases) and 60 patients without post operative complications (controls) matched for age and sex. RESULTS: The uni-variable analysis found that albumin (p=0.03), hematocrit (p=0.004), early enteral nutrition (p<0.01), stage of gastric cancer (p=0.013), behaved as variables associated with the development of postoperative complications. However, in this multivariable analysis, only early enteral nutrition (p=0.014), hematocrit (0.019) and pathological stage (0.013), showed statistically significant association. CONCLUSIONS: The early enteral nutrition administered by nasoenteral tube in the immediate postoperative period, with the hematocrit level and the anatomopathological disease stage is associated with statistically decreased postoperative complications in patients undergoing radical surgery for gastric cancer.
Assuntos
Adenocarcinoma/cirurgia , Nutrição Enteral , Síndromes Pós-Gastrectomia/prevenção & controle , Neoplasias Gástricas/cirurgia , Idoso , Estudos de Casos e Controles , Feminino , Gastroenterostomia , Hematócrito , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes Pós-Gastrectomia/epidemiologia , Período Pós-Operatório , Albumina Sérica/análiseRESUMO
A retrospective study of gastric adenocarcinoma treated with surgery as curative attempt was performed at the Oncology Service, in the Hospital Regional 20 de Noviembre, ISSSTE. Morbidity and mortality of the surgical procedures were evaluated, the significance of several risk factors and the survival impact of adjuvant chemotherapy with 5-fluorouracil (5-FU) and mitomycin C (MMC). In the period from 1975 to 1991 a total of 483 new cases were seen. In only 54 patients (11.2%) was it possible to undertake a curative resection. The patients were assigned to three groups of treatment: surgery alone (14 cases), surgery + 5-FU (19 cases), and surgery + 5-FU+MMC (21 cases). Three different types of surgical techniques are regularly performed in our service for gastric cancer treatment: Billroth II distal gastrectomy, total gastrectomy with Roux-En-Y reconstruction, and esophagogastrectomy with esophagogastrostomy. Surgical morbidity and mortality was low, with 9% of duodenal stump fistulas and 27% with partial stenosis of esophagojejunostomy; the operative mortality was zero. Chemotherapy toxicity was transient and low, no related deaths were recorded. The prognostic factors associated significantly with survival were lymph node status and tumor penetration. The histologic differentiation as well as the tumor location and type of surgery had no significance. The estimated 5-year survival of the patients treated with surgery alone was 62%, while that of the patients treated with surgery plus chemotherapy was 38%. These groups were not comparable, however, because of important differences in their prognostic factors. The groups treated with 5-FU alone or in combination with MMC had no survival difference between them.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Adenocarcinoma/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fluoruracila/uso terapêutico , Gastrectomia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/mortalidade , Idoso , Anastomose em-Y de Roux/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Quimioterapia Adjuvante , Terapia Combinada , Enterostomia/efeitos adversos , Esôfago/cirurgia , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Gastrectomia/mortalidade , Humanos , Tábuas de Vida , México/epidemiologia , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Mitomicina/efeitos adversos , Análise Multivariada , Síndromes Pós-Gastrectomia/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Análise de Sobrevida , Resultado do TratamentoRESUMO
The clinical onset of celiac sprue (CS) may be precipitated by upper digestive tract surgery. We report a series of 10 patients who developed CS after diverse types of peptic ulcer surgery. Six were male and 4 female. Gastrectomy with Billroth II anastomosis was performed in 5 patients, truncal vagotomy and pyloroplasty in 2, parietal cell vagotomy and pyloroplasty in 1, and vagotomy with gastrojejunal anastomosis in 2. We found that eight patients had had previous symptoms that suggested CS. Symptoms occurred early in the postoperative period. Severe diarrhea and striking weight loss were the most prominent clinical findings. The response to gluten-free diet was independent of the type of surgical procedure performed and was similar to that observed in the general celiac population.