الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Gastric cancer is the fourth most common cancer and the second leading cause of
cancer-related death worldwide. In 200P, about 880 000 people were diagnosed with gastric
cancer and approximately 650 000 died of the disease.Because of the low cure rate and the
advanced stage at which many patients present, palliative strategies are an essential
component of gastric cancer management.Surgical palliation of advanced gastric cancer may
include resection or bypass, alone or in combination with endoscopic or percutaneous
interventions. Such interventions have been proposed not only to improve symptom control,
but also to eliminate potential complications (bleeding, obstruction, pain, perforation,
debilitating ascites) caused by the primary tumor.Palliative or noncurative resection is defined
by the presence of any gross or microscopic residual tumors remaining postoperatively
regardless of whether the surgical attempt was originally palliative or curative.The proponents
for palliative gastrectomy assume that by removing the major tumor bulk by partial or total
gastrectomy, one can avoid complications arising from the tumor such as tumor bleeding,
obstruction and perforation. Moreover, by reducing the risk of occurrence of tumor
complication, one can reduce the number of recurrent hospital admissions and, hence, the
patient can enjoy a better quality of life (QOL) and a longer hospital-free survival (HFS)
period. The other possible advantage of performing palliative resection is cytoreduction. By
removing the tumor bulk, theoretically, palliative chemotherapy or radiotherapy can be more
effective and less tumor-related complications will occur during therapy.Conversely,
opponents would argue that surgical intervention is associated with significant risks. Most
patients with advanced malignancy have poor physical and nutritional status, and treating
their symptoms with a major surgical resection may result in a higher rate of morbidity and
mortality. This is especially true in the case of resection of a proximal gastric carcinoma,
which involves a total gastrectomy or an esophagogastrectomy.In order to settle this debate
down, many studies were carried on to evaluate the palliative resection regarding its
morbidity, mortality, survival benefit, and its effect on patient quality of life. Many works
found a reasonable risk, a survival benefit and a positive effect on quality of life. But more
and more patients are needed to confirm these results or disclaim them. We add our work to
the literature hoping for finding a good palliative procedure for gastric cancer patients. This is
a study of sixty patients who were proved to have advanced stomach cancer and underwent
resection surgery. The study was designed to detect the incidence of post-operative morbidity
and mortality rates, what factors affect the outcome of surgery, rate of hospital readmission
which indicates the quality of life in this group of patients. The study also recorded the post-
operative short term survival rates which gives an indicator to the overall survival
rates.Postoperative morbidity rates recorded in the literature varies greatly from 6% to 65%.
In our study postoperative morbidity results was 23%. In review of previous studies;
palliative resection mortality rates ranges approximately from 4% to 27%. Our study stated a
6.7% mortality rate which is in line with results of these studies.The study included 34 males
and 26 females represent, with mean of age (53 years) for all participants. There was no
relation between age and postoperative outcome according to our findings.Fifteen patients
have had medical disease (25%). We found that pre-existing medical condition significantly
affects the postoperative morbidity and mortality rates. There was no relation between extent
of resection and technique of reconstruction to the postoperative outcome according to our
data.Postoperative hospital stay days was about eight days which is reasonable period and
none of our patients needs hospital readmission which means a good hospital free survival
period. The median survival rate was 15 months, but it is a short term survival over follow up
period of about 22 months.