The diagnosis of the @entity5 of the stomach is generally late (stages III and IV to a medium value of 80% of @entity1 ). Therefore it is necessary a surgical treatment in order to effectuate the extirpation of the lesions and to warn or to treat the complications in course of the @entity5 . The indications and the results of the palliative total gastrectomy (PTG) are analyzed in the present study. Between 1992 and 1999 there were studied retrospectively and prospectively during three successive periods of time, 217 @entity1 (pts.) with PTG. This group of pts. represents 22.1% of the total number of pts. operated on for @entity356 ( @entity189 particularly). The indication of PTG was established only after one complex evaluation of the every @entity1 from the point of view of his general and biological status. 142 (65.4%/217) of the analyzed pts. presented at the admission in the hospital various complications of the @entity5 ( @entity356 , digestive @entity548 , loco-regional invasion). The lymph nodes @entity3 and the systemic @entity3 (in the liver especially) as well as the invasion in the neighbouring viscera imposed sometimes the extension of the PTG with partial or total extirpation of the invaded organs. A proportion of 61% pts. were submitted to those type of enlarged surgical interventions without radical intentions; all the operated pts. remained by necessity in R1 or R2 types of operations. The reconstructive preferred @entity254 was effectuated with an Y jejunal ansa    la Roux completed or not by a "J" reservoir. Microscopically pathologic lesions were: @entity420 and @entity189 (82%), followed by primitive @entity706 (11.5%), and others malignant forms of lesions (approximately 6%). The general perioperative morbidity was 32.5% divided in: 12.3% having a surgical cause (the majority anastomotic leakages +/- septically complications or precocious occlusions); 20.2% complications depending by the general status and altered biology of the @entity1 . Perioperative mortality was 10.1% (22 pts.) comparable with other experiences published in the international literature in those forms of advanced @entity356 operated by PTG. The average outcome of the operated followed pts. was 16-18 month (extremes 12 months and 29 months). A better quality of life and a variable disease-free period was obtained. As a conclusion we think that the PTG is a advantageous modality of surgical treatment with an acceptable rate of perioperative morbidity and mortality. The outcome of operated pts. is superior comparable with that of nonoperated pts. or with that secondary to other palliative surgical interventions. The importance of adjuvant treatment (chimeo- or radiotherapy) remain to be appreciated in the future.

[Palliative total gastrectomy in advanced XXXX of the stomach].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhages'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplastic disease', 'malignant disease', 'malignancies'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity189 :: ('MESH:D002277', 'Disease') :: ['carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer', 'gastric different stenosis', 'gastric malignancies']
@entity5 :: (MESH:D009369,Disease) :: ['malignancies']
