Multivisceral Resections in Advanced Gastric Cancer-Case Report
Journal Title: JURNALUL DE CHIRURGIE [JOURNAL of SURGERY] - Year 2017, Vol 13, Issue 4
Abstract
Background: Gastric cancer is an important cause of death in worldwide, despite the progress achieved through screening programs. Multivisceral resections are dictated by R0 resection gold, but also by the histopathological type of the neoplasm involved. Case report: A 64-year-old patient was admitted in Surgery department for epigastric abdominal pain, haematemesis, anorexia, weight loss. Superior digestive endoscopy revealed a reduced stomach in size, inextensible at insufflation, with a malignant ulceration, unresponsive to proton pump inhibitor (PPI) treatment. The clinical and endoscopic context required surgery and intraoperative it was detected a tumor block that includes the stomach, transverse colon, spleen and pancreas, undergoing total gastrectomy, distal spleno-pancreatectomy, subtotal colectomy with eso-jejunal anastomosis on Y Roux loop, ileo-sigmoid anastomosis, suture of the proximal pancreatic tissue. Postoperative course was favorable with discharge of the patient on the 11th postoperative day. The histopathological examination revealed a diffuse carcinoma with linitis plastica appearance. After oncological treatment with imatimib, no endoscopic and imagistic signs of tumor recurrence are seen at 6 months apart. Conclusions: Multivisceral resections in the advance gastric cancer T4 stage represent the only surgical procedure to obtain an R0 type resection. This should be done whenever technically is possible, but favorable outcomes in distance survival are recorded in mesenchimal forms and less in adenocarcinomas.
Authors and Affiliations
Răzvan Marius Ion, Mircea Mureșan
Keywords
Related Articles
- EP ID EP310908
- DOI -
- Views 88
- Downloads 0
Clostridium Difficile Infection - An Optimistic View
Background: Clostridium difficile infection (CDI) is one of the most common infectious complications affecting vulnerable patients, i.e., after surgery or immunosuppressive therapies, posing a significant risk in an onco...
Obesity is Linked with Inflammation-Evaluation of Subclinical Inflammatory Status in Obese Patients
Background: Obesity is one of the most important public health; it seems that inflammation is a pathogenic pathway between obesity and its associated comorbidities. The aim of the study was to evaluate the status of seru...
Rapidly Progressive Osteolysis of the Femoral Head Following An Acetabular Fracture - Case Report
Posttraumatic osteolysis is a rare complication of fractures. We present a case of massive, rapidly progressive osteolysis of the femoral head following a fracture of the acetabulum. A 45 years old male patient suffered...
Approach to a Patient with Post Laparoscopic Cholecystectomy Bile Leak
With the widespread practice of laparoscopic cholecystectomy and the advancements in imaging and endoscopic therapy the management of bile leaks following cholecystectomy has evolved over the years. Majority of the bile...
Fistulas after Low Anterior Resection with TME
Despite advances in modern anastomotic techniques for colorectal surgery, anastomotic fistulas are still considered a dreaded complication, with a reported rate varying from 2 to 25%. Although fistulas can appear after a...