Outcome after emergency surgery in gastric cancer patients with free perforation or severe bleeding

Background/Aims: This study was conducted to evaluate the clinicopathologic characteristics and surgical outcome of perforated or bleeding gastric cancer patients. Methods: Twenty-six gastric cancer patients undergoing emergency surgery for free peroration (n=13) or severe bleeding (n=13) were reviewed. Results: In the perforation group, tumors were mainly located in the greater curvature and anterior wall, but in the bleeding group, they were mainly in the lesser curvature. Three (23%) patients in the perforation group and 7 (54%) in the bleeding group received potentially curative resections (p=0.11). The postoperative morbidity rate and mortality rate were 31 (8/26) and 8% (2/26), respectively. Median survival time after operation was 5.5 months. One patient in the perforation group and 3 patients in the bleeding group who underwent curative resection survived more than 30 months without recurrence. Three factors were found to be associated with improved survival after emergency surgery: potentially curative resection; TNM stage, and the absence of postoperative complications. Conclusion: Emergency surgery for gastric cancer patients with perforation or severe bleeding is associated with a low curative resection rate and a high postoperative complication rate. However, long-term survival can be expected in those patients who underwent curative resection with earlier stage gastric cancer. Copyright (c) 2006 S. Karger AG, Basel