Korean J Thorac Cardiovasc Surg.  2014 Jun;47(3):269-274.

Surgical Treatment of Anastomotic Recurrence after Gastrectomy for Gastric Cancer

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. youngmog.shim@samsung.com

Abstract

BACKGROUND
The purpose of this study was to evaluate the outcome of reoperation with curative intent for the treatment of anastomotic recurrent gastric cancer.
METHODS
Ten patients with anastomotic recurrence of gastric cancer who underwent reoperation from November 1995 to February 2011 were analyzed retrospectively. The time interval between the first operation and reoperation, recurrence pattern, type of surgery, survival, and postoperative outcome were analyzed.
RESULTS
The average time to recurrence after initial surgery was 48.8 months (median, 23.5 months). Of the ten patients, eight (80.0%) had recurrence at the esophagojejunostomy, one (10.0%) at the esophagogastrostomy, and two (20.0%) at the esophagus. Among these patients, five had combined metastasis or invasion to major organs in addition to anastomotic recurrence. Complete resection was achieved in five patients (50.0%), and incomplete resection or bypass surgery was performed in the remaining five patients (50.0%). The overall median survival time was 7.0 months (range, 2.2 to 105.5 months). The median survival time following complete resection and palliative surgery (incomplete resection or bypass surgery) was 28.1 months (range, 4.2 to 105.5 months) and 5.5 months (range, 2.2 to 7.5 months), respectively.
CONCLUSION
Surgical resection of anastomotic recurrent gastric cancer should be implemented only in selected patients in whom complete resection is possible.

Keyword

Neoplasm recurrence; Anastomosis; Surgical procedures, operative; Stomach neoplasms

MeSH Terms

Esophagus
Gastrectomy*
Humans
Neoplasm Metastasis
Palliative Care
Recurrence*
Reoperation
Retrospective Studies
Stomach Neoplasms*
Surgical Procedures, Operative
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