Surgical management of patients with bowel obstructions secondary to gastric cancer

Table 1 Factors on presentation associated with a malignant etiology of the small-bowel obstruction

Factors	Value
All	65 (100.0)
Sex
Female	11 (16.39)
Male	54 (83.1)
Age (yr)
< 70	45 (69.2)
≥ 70	20 (30.8)
Site
Lower	41 (63.1)
Middle	8 (12.3)
Upper	16 (24.6)
Diffuse	0 (0.0)
Comorbidities
Yes	42 (64.6)
No	23 (35.4)
Surgery
Subtotal gastrectomy	33 (50.8)
Total gastrectomy	19 (29.2)
Extended total gastrectomy	13 (20.0)
Types of digestive reconstruction
Billroth I	20 (30.8)
Billroth II	15 (23.1)
Roux-en-Y	30 (46.1)
Grading
Well differentiated	22 (33.8)
Moderately differentiated	22 (33.8)
Poorly differentiated	21 (32.4)
Undifferentiated	0 (0.0)
T stage
T1	0 (0.0)
T2	21 (32.3)
T3	38 (58.5)
T4	6 (9.2)
No. metastatic nodes
N0	8 (12.3)
N1	22 (33.8)
N2	23 (35.4)
N3	12 (18.5)
M stage
M0	65 (100.0)
M1	0 (0.0)
Intra-abdominal chemotherapy
Yes	35 (53.8)
No	30 (46.2)
Postchemotherapy
Yes	55 (84.6)
No	10 (15.4)
Recurrence in PET/CT
Yes	31 (47.7)
No	34 (52.3)
Re-surgery
Yes	27 (41.5)
No	38 (58.5)

PET/CT: Positron emission tomography/computed tomography.

Table 2 Recurrence site, number and standardized uptake value of recurrence in positron emission tomography/computed tomography

Variables		n	SUV mean (range)
Recurrence	Yes	31	7.3 (2.6-28.3)
	No	34	/
Recurrence site	Locoregional recurrence	2	6.8 (4.1-16.2)
	(Remnant stomach or anastomosis site)
	Distant metastasis	29	7.9 (2.6-28.3)
	Lymph-node	16	7.5 (2.6-28.3)
	Liver	8	8.0 (2.8-15.5)
	lung	6	7.1 (2.6-14.2)
	Other site (bone, skin, etc.)	10	6.2 (3.2-12.5)
	Peritoneum	12	5.4 (2.7-11.2)

SUV: Standardized uptake value.

Table 3 The clinicopathologic factors of the 65 patients

Factors	Survive (n)	Death (n)	Univariate analysisPvalue	Multivariate analysisPvalue
Sex			0.751
Female	6	5
Male	26	28
Age (yr)			0.180
< 70	25	20
≥ 70	7	13
Site			0.336
Lower	20	21
Middle	1	7
Upper	11	5
Diffuse	0	0
Comorbidities			0.798
Yes	20	22
No	12	11
Surgery			0.683
Subtotal gastrectomy	17	16
Total gastrectomy	10	9
Extended total gastrectomy	5	8
Types of digestive reconstruction			0.446
Billroth I	12	8
Billroth II	6	9
Roux-en-Y	14	16
Grading			0.241
Well differentiated	11	11
Moderately differentiated	8	14
Poorly differentiated	13	8
Undifferentiated	0	0
T stage			0.447
T1	0	0
T2	8	13
T3	21	17
T4	3	3
No. metastatic nodes			0.105
N0	1	7
N1	11	11
N2	14	19
N3	6	6
Intra-abdominal chemotherapy			0.459
Yes	19	16
No	13	17
Postchemotherapy			0.511
Yes	26	29
No	6	4
Recurrence in PET/CT			0.000	0.000
Yes	2	29
No	31	3
Re-surgery			0.804
Yes	14	13
No	18	20

PET/CT: Positron emission tomography/computed tomography.

Table 4 Types of surgery performed for small-bowel obstruction

Procedure	n
Open and close	10
R0 resection	2
Bypass	1
Bowel resection	7
Adhesiolysis	7

Table 5 Outcomes variables of the 65 patients

Variables	No recurrence in PET/CT		Recurrence in PET/CT
	Surgical management	Non-surgical management	Surgical management	Non-surgical management
Mean length of stay (d)	10.5 ± 2.3	18.2 ± 8.7	8.2 ± 3.1	19.1 ± 9.6
30-d re-admission	0.00%	21.10%	25.00%	26.10%
In-hospital mortality	0.00%	0.00%	0.10%	0.00%
Overall complications	53.30%	0.00%	33.30%	0.00%

PET/CT: Positron emission tomography/computed tomography.