Kuang F, Wang J, Wang BQ. Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding. World J Gastrointest Surg 2023; 15(7): 1423-1433 [PMID: 37555107 DOI: 10.4240/wjgs.v15.i7.1423]
Corresponding Author of This Article
Jian Wang, MM, Attending Doctor, Department of Emergency, The First Affiliated Hospital of University of South China, No. 69 Chuanshan Road, Hengyang 421001, Hunan Province, China. wangjian13988@163.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2023; 15(7): 1423-1433 Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1423
Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding
Feng Kuang, Jian Wang, Bai-Qi Wang
Feng Kuang, Jian Wang, Department of Emergency, The First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
Bai-Qi Wang, Department of Radiation Oncology, The Second Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
Author contributions: Wang J designed the study; Kuang F and Wang BQ performed the experiments and analyzed the data; Kuang F wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was approved by Ethics Committee of The First Affiliated Hospital of the University of South China.
Informed consent statement: The data used in the study were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of The First Affiliated Hospital of University of South China. All patient data obtained, recorded, and managed only used for this study, without any harm to the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Wang, MM, Attending Doctor, Department of Emergency, The First Affiliated Hospital of University of South China, No. 69 Chuanshan Road, Hengyang 421001, Hunan Province, China. wangjian13988@163.com
Received: April 6, 2023 Peer-review started: April 6, 2023 First decision: April 19, 2023 Revised: May 7, 2023 Accepted: May 24, 2023 Article in press: May 24, 2023 Published online: July 27, 2023
ARTICLE HIGHLIGHTS
Research background
Gastric cancer (GC) is a malignant tumor that originates from the gastric mucosal epithelium, and it has the highest incidence rate among various malignant tumors in China. Surgery is the main clinical treatment for GC.
Research motivation
The incidence rate of GC is extremely high, and surgical treatment is the primary approach to curing this disease.
Research objectives
This study aims to explore the clinical value of giving radical surgery and palliative surgery based on exploratory laparotomy in patients with GC combined with upper gastrointestinal bleeding.
Research methods
A total of 89 GC patients were selected and divided into two groups - the palliative group and the radical resection group. The two groups were compared in terms of various indicators such as the operation time, intraoperative blood transfusion, postoperative anal exhaust time, bed time, duodenal stump rupture, anastomotic obstruction complications, and the postoperative immune function, immunoglobulin and tumor markers, inflammatory factors, surgical effect, postoperative quality of life recovery, as well as patient monitoring for postoperative survival and tumor recurrence.
Research results
The radical resection group had shorter intraoperative blood loss and anal exhaust time compared to the palliative group, but did not show a significant difference in the occurrence of postoperative complications. Additionally, the postoperative immune function index and immunoglobulin levels of the radical resection group were higher than those of the palliative group, while the levels of tumor markers and inflammatory factors were lower in the radical resection group. The surgical efficacy and postoperative quality of life of the radical resection group were also higher than those of the palliative group, and the postoperative survival rate was also higher for the radical resection group.
Research conclusions
Laparotomy combined with radical surgery can result in a shorter postoperative hospital stay, improved immune function, increased surgical efficacy, enhanced quality of life recovery, higher survival rate, and reduced chance of tumor recurrence.
Research perspectives
Due to the particularity of GC patients, they must be careful in selecting their treatment approach. Laparotomy combined with radical surgery can effectively enhance surgical efficacy, improve immune function, reduce tumor recurrence rate, and provide a safe and controllable treatment option. Therefore, this approach is worth promoting and applying. On the premise of strictly controlling the indications, laparotomy combined with radical surgery should be selected whenever possible.
