Influence of Peritoneal Carcinomatosis on Perioperative Outcome in Palliative Gastric Bypass for Malignant Gastric Outlet Obstruction - a Retrospective Cohort Study

Overview

Journal World J Surg Oncol

Publisher Biomed Central

Specialties General Surgery
Oncology

Date 2020 Feb 2

PMID 32005250

Citations 2

Authors

Jan Bednarsch

Zoltan Czigany

Daniel Heise

Henning Zimmermann

Joerg Boecker

Tom Florian Ulmer

Ulf Peter Neumann

Christian Klink

Affiliations

Soon will be listed here.

Abstract

Background: Malignant gastric outlet obstruction (GOO) is commonly associated with the presence of peritoneal carcinomatosis (PC) and preferably treated by surgical gastrojejunostomy (GJJ) in patients with good performance. Here, we aim to investigate the role of PC as a risk factor for perioperative morbidity and mortality in patients with GOO undergoing GJJ.

Methods: Perioperative data of 72 patients with malignant GOO who underwent palliative GJJ at our institution between 2010 and 2019 were collected within an institutional database. To compare perioperative outcomes of patients with and without PC, extensive group analyses were carried out.

Results: A set of 39 (54.2%) patients was histologically diagnosed with concomitant PC while the remaining 33 (45.8%) patients showed no clinical signs of PC. In-house mortality due to surgical complications was significantly higher in patients with PC (9/39, 23.1%) than in patients without PC (2/33, 6.1%, p = .046). Considerable differences were observed in terms of surgical complications such as anastomotic leakage rates (2.8% vs. 0%, p = .187), delayed gastric emptying (33.3% vs. 15.2%, p = .076), paralytic ileus (23.1% vs. 9.1%, p = .113), and pneumonia (17.9% vs. 12.1%, p = .493) without reaching the level of statistical significance.

Conclusions: PC is an important predictor of perioperative morbidity and mortality patients undergoing GJJ for malignant GOO.

Citing Articles

Gastric cancer with positive peritoneal cytology: survival benefit after induction chemotherapy and conversion to negative peritoneal cytology.

Valletti M, Eshmuminov D, Gnecco N, Gutschow C, Schneider P, Lehmann K World J Surg Oncol. 2021; 19(1):245.

PMID: 34404403 PMC: 8371873. DOI: 10.1186/s12957-021-02351-x.

Current management of malignant bowel obstructions: a survey of acute care surgeons and surgical oncologists.

Bleicher J, Lambert L, Scaife C, Colonna A Trauma Surg Acute Care Open. 2021; 6(1):e000755.

PMID: 34222676 PMC: 8211049. DOI: 10.1136/tsaco-2021-000755.

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