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Tytuł pozycji:

Surgical treatment of gastric cancer in a community hospital in Brazil: who are we treating and how?

Tytuł :
Surgical treatment of gastric cancer in a community hospital in Brazil: who are we treating and how?
Autorzy :
Nagem R; Department of Surgery, Unacon-Betim, Av. Edmeia Lazarotti, 3800, Betim, Brazil, .
Bicalho LG
Lourenço LG
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Źródło :
Journal of gastrointestinal cancer [J Gastrointest Cancer] 2013 Dec; Vol. 44 (4), pp. 410-6.
Typ publikacji :
Journal Article
Język :
English
Journal Info :
Publisher: Springer Science+Business Media Country of Publication: United States NLM ID: 101479627 Publication Model: Print Cited Medium: Internet ISSN: 1941-6636 (Electronic) NLM ISO Abbreviation: J Gastrointest Cancer Subsets: MEDLINE
Imprint Name(s) :
Publication: 2010- : New York : Springer Science+Business Media
Original Publication: New York, NY : Humana Press
MeSH Terms :
Gastrectomy*
Hospitals, Community*
Lymph Node Excision*
Adenocarcinoma/*surgery
Stomach Neoplasms/*surgery
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Brazil ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Survival Rate
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Entry Date(s) :
Date Created: 20130702 Date Completed: 20140714 Latest Revision: 20181113
Update Code :
20200716
DOI :
10.1007/s12029-013-9516-4
PMID :
23812916
Czasopismo naukowe
Purpose: Surgical treatment of gastric cancer has risks, and the current trend in developed countries is to centralize cases in high-volume centers. Many countries, however, particularly the developing ones, have to rely in low-volume centers for the most part of gastric cancer operations. We aimed to verify the characteristics of the patients and tumors as well as the in-hospital outcomes in a community hospital in Brazil treating gastric cancer.
Methods: This is a retrospective study on patients undergoing surgical treatment of gastric adenocarcinoma at a community hospital in Brazil. The authors reviewed demographic, clinical, pathological, and perioperative data.
Results: A total of 28 patients were operated on during the study period. Mean age was 69.5 years, 53.6% were male, 67.9% had anemia, 78.5% had ASA score ≥ 3, 89.3% were at nutritional risk, intestinal/diffuse ratio was 1.6, 68.5% had tumor ≥ 6 cm, involvement of lower/middle third of the stomach occurred in 96.4%, 73.7% had serosal invasion, 79% had stage III disease, median number of dissected nodes was 23, median operative time was 255 min, 21.4% had urgent procedures, 67.8% had curative surgery, 50% had distal gastrectomy, 43.5% had a Billroth I, median length of stay was 17 days, 53.6% had some admission to the intensive care unit, 21.4% required relaparotomy, 25% had wound infection/dehiscence, and mortality was 66.7/18.2% (urgent/non-urgent surgery).
Conclusion: We treat elderly malnourished patients with multiple comorbidities and advanced cancer. Improvement is required in lymph node dissection, non-surgical therapies, and critical care.

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