MULTIVISCERAL RESECTIONS IN CASES OF LOCALLY ADVANCED GASTRIC CANCER. PERIOPERATIVE RESULTS IN A HIGH-VOLUME CENTER

Introduction. At the time of diagnosis, gastric cancer is usually an advanced disease. This is related to poor prognosis. Despite of reported improvement of perioperative results after neoadjuvant therapy In cases of locally advanced disease without evidence of distant metastases, only multivisceral resections may be considered as an attempt to achieve better outcome. Typically, these are very challenging surgical interventions involving different organs in the supramezolic part of the abdominal cavity, requiring great practical experience from the surgical team with potential risks of serious complications. Aim. To analyze the perioperative results in a group of 59 patients with multivaseral resections of locally advanced T4 gastric cancer without data of distant metastases in hepatobiliary and pancreatic surgery clinic with a large volume of activity. Material and method. This report is based on a series of 59 patients operated in the Hepato-billiary, Pancraetic and General Surgery Department with T4 locally advanced gastric carcinoma and performed multivaseral resections. This series is subject to a retrospective study. Results. All patients in the reported group had macroscopic involvement of adjacent organs or anatomical structures without evidence of distant peritoneal or liver dissemination. 36 (61.0%) men and 23 (39.0%) women between the age of 23 and 79 were operated on. Pancreatic resections were performed in 38 (64.4%) patients. In the study group, 2 patients died, with a perioperative mortality rate of 3.3%. Perioperative complications were recorded in 13 patients (22.0%). The most common complication is the postoperative development of pancreatic fistula. The median hospital stay is 10.7 days. Conclusion. In selected patients, multivisceral resections for locally advanced gastric cancer by an experienced HBP surgical team are associated with acceptable perioperative outcomes in terms of complications and mortality.