Outcomes of surgical approaches for gastric cancer with portal hypertension

Abstract

Objective 

The influence of surgical approaches on patients with gastric cancer with portal hypertension is unknown. The aim of the study was to investigate the outcomes in such patients who had undergone curative surgery for gastric cancer.

Patients and methods 

The clinical data of 60 patients with portal hypertension undergoing curative surgery for gastric cancer or simultaneous surgery for portal hypertension were retrospectively analyzed.

Results 

Radical gastrectomy alone had no tremendous impact on postoperative liver function, but simultaneous surgery for portal hypertension affected patients’ liver function dramatically (P<0.001). For those who underwent surgery for portal hypertension simultaneously, the incidence of complications on patients with Child’s B was much higher than that of patients with Child’s A (P<0.001). However, the incidence of complications did not differ between Child’s A and Child’s B patients who underwent radical gastrectomy alone. In addition, patients undergoing simultaneous surgery for portal hypertension displayed more severe complications than did those who underwent radical gastrectomy alone (P<0.001). Age, tumor stage, and simultaneous surgery for portal hypertension were the independent risk factors for the deterioration of liver function (P<0.05), and the survival time of patients undergoing simultaneous surgery for portal hypertension was significantly shorter than that of patients undergoing radical gastrectomy alone (P<0.05).

Conclusion 

Individualized selection of surgical approaches for the treatment of gastric cancer with portal hypertension should be decided by preoperative liver function. Simultaneous management of portal hypertension was not advocated.