Diagnosis And Treatment Of Acute Perforation Of Gastric Cancer

Objective:To investigate clinical characteristics and diagnosis methods of acute perfarated gastric cancer, and the influence of the Postoperative survival, due to different surgical therapies in order to improve the level of diagnosis and treatment. Method:Based on the retrospectively analysis of the surgery clinical data from42patients with acute perforation gastric cancer treated in the our hospital (Yantai City Chinese Medicine Hospital) and Qingdao Municipal Hospital between2001-2012,and comparison of the clinical features of acute gastric perforation, different diagnostic methods to help diagnosis, according to the patient’s specific condition and intraoperative exploration, three different surgical methods were taken:Perforation repair, palliative tumor resection, gastrectomy, Observed after surgery on survival of patients.Results:Among,42patients with acute perforation gastric cancer surgery,34patients were diagnosed of acute gastric perforation immediately with preoperative abdominal CT before surgeries.8patients were misdiagnosed as ulcer perforation, through rapid intraoperative pathological examination, misdiagnosis rate was19.04%.37patients were cured,3patients died after surgery. Simple perforation repair was performed in10cases; palliative resection of the tumor in17patients (4of which were in perforation repair after3weeks, the line second stage surgery to palliative gastrectomy); the radical gastrectomy15cases (of which D16cases, D2). The mean survival time:simple perforation repair7.2months, palliative resection of the tumor was15.6months, the radical gastrectomy28.3months. Postoperative deaths are simple perforation repair cases, the cause of death was severe abdominal infection is difficult to control, partial perforation and serious medical illness can not be effectively correct the cause multiple organ failure (multiple organ failure, MOF).Conclusion:The acute perforation of gastric cancer is a Serious complications of acute gastric perforation for advanced gastric cancer. Diagnosis once established, should take an active surgical treatment, A reasonable choice of intraoperative surgical approach, To reduce the mortality of patients with gastric perforation, reduce complications and improve quality of life, Extend the survival of patients with significant differences.. Analysis shows: Palliative resection in patients with postoperative complications and survival was significantly better than patients with perforation repair, Radical surgery surgery patients with postoperative complications and survival time significantly better than palliative resection. There is a significant difference (P<0.01), with statistically significant. The acute gastric perforation, As long as the conditions permit due the possibility of radical surgery or palliative resection of the tumor.