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SM ISO690:2012 BORTĂ, Eduard, HOTINEANU, Adrian, BURGOCI, Serghei, HOTINEANU, Adrian. Optimization of the surgical management of gastric cancer. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 305. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | ||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | ||||||
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Rezumat | ||||||
Background: The stomach IS one of the most frequently localization of malignant neoplastic disease in the digestive tract. The incidence of gastric cancer is declining in the world, but it remains very high, occupying the III-IV place in the structure of oncological morbidity. Gastric cancer (GC) over the years remains a surgical challenge not only in the Republic of Moldova, but also in the world. Surgical treatment throughout evolution remains a major method, evolving from the unique treatment option to a multidisciplinary approach. Objective of the study. Over the years, Surgery Clinic 2 has also changed surgical tactics, from simple gastric resection to total gastrectomies or subtotal gastrectomies associated with extensive lymphodissection, metastasctomy, or multivisceral resections. Material and Methods. We analyzed 270 patients admitted to Surgery 2 clinic during the years 2005-2021 with the diagnosis of GC. Out of which 201 (74,4%) were subjected to the potential curative treatment (surgical resection), 69 (25,6%) benefited only from palliative treatment. Complications of gastric cancer (profuse haemorrhage, perforation with peritonitis) have been the cause of vital signs surgery in 21 cases. Results.Overall survival at 5 years at all stages 35%. Overall survival in Stage II and III patients after D1, D2 and D3 lymphadenectomy is 37%, 42% and 43%. Patients operated in the locally advanced stage IV have similar survival rates of 26-29% in all lymphadenectomy modalities. Similarly, R0 resection provides overall 5-year survival and recurrence free survival in Stage II, III (40%) versus R1 (33%) and no difference in locally advanced stage IV (27%). Conclusion. With the progression of adjuvant treatment, surgical attitude for GC has also changed. Clinical studies and modern technical developments have greatly facilitated the use of a multimodal approach to the treatment of gastric cancer. The surgical approach is varied from minimally invasive endoscopic interventions to total gastrectomies with extensive lymphadenectomy and plurivisceral resections. Gastrectomy associated with D2 lymphadenectomy has become standard surgery in any stage of GC. |
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Cuvinte-cheie gastric cancer, gastrectomy, lymphadenectomy, cancer gastric, gastrectomie, limfadenectomie |
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