This report is a clinical review of 39 patients with gastric cancer perforation who under-went surgical operation at the Department of Surgery, School of Medicine, Chonnam National University from January 1974 to December 1983.
The following results were obtained.
1) Of 573 patients with gastric cancer submitted to surgical treatment, 39 patients (6.8%) were perforated.
2) The male to female ratio was 6.8: 1. The age distribution indicated a prominent incidence between the age of 6th and 8th decade.
3) The seasonal distribution revealed prominent incidence in summer (35.9%).
4) The duration of symptoms more than three years was 33.3%, between two years and three years 25.7% and below one month was 15.4%. Subjective symptoms of gastric cancer were epigastric discomfort (87.2%), hunger pain (69.2%) and indigestion (61.5%).
5) Abdominal tenderness was noted in all patients. Physical examination on admission rev-ealed abdominal tenderness (100%), rebound tenderness (79.5%) and rigidity (71.8%).
6) In hemoglobulin value on admission, hemoconcentration and anemia were noted in 7 cases (18.0%) and 8 cases (20.5%) respectively and leucocytosis and leucocyiopenia in 17 cases (43.6%) and 4 cases (10.3%) respectively.
7) The anatomical locations of cancer perforation were antrum and body. Lesser curvature of anturm was the most common location (76.9%). The most common size of perforated les-ion was 5~10 mm (38.5%).
8) Lymph node metastasis was noted in all examined patients.
9) Distant metastasis was noted in 11 cases (28.2%) and the sites of metastasis were liver, pancreas, omentum and peritoneum.
10) As for the operative procedures, the most common operative procedure was subtotal gastrectomy (56.4%) and the other procedures were simple closure(28.2%), total gastrectomy (10.3%) and simple closure with gastrojejunostomy (2.5%).
11) Early postoperative complications were noted in 11 cases (28.2%); wound infection was the most common (6 cases) and the other complications were adhesive ileus (3 cases), sepsis (2 cases) and acute renal failure (1 case).
12) Operative mortality was 7.7/, the cause of death were sepsis (2 cases) and acute renal failure (1 case).
13) The associated diseases with gastric cancer perforation were noted in 13 cases (33.3%). Pulmonary tuberculosis was the most common.
|