This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Outcomes after prophylactic gastrectomy for hereditary diffuse gastric cancer. BJS 2018; 105: e176-e182.
Published: 17th January 2018
Authors: R. T. van der Kaaij, J. P. van Kessel, J. M. van Dieren, P. Snaebjornsson, O. Balagué, F. van Coevorden et al.
Background
Patients with hereditary diffuse gastric cancer and a
Method
All consecutive individuals undergoing a prophylactic gastrectomy for a
Results
In 25 of 26 patients, intraoperative frozen‐section examination (proximal resection margin) was used to verify complete removal of gastric mucosa. All definitive resection margins were free of gastric mucosa, but only after the proximal margin had been reresected in nine patients. In the first year after surgery, five of the 26 patients underwent a relaparotomy for adhesiolysis (2 patients) or jejunostomy‐related complications (3 patients). Six patients were readmitted to the hospital within 1 year for nutritional and/or psychosocial support (4 patients) or surgical reintervention (2 patients). Mean weight loss after 1 year was 15 (95 per cent c.i. 12 to 18) per cent. For the 25 patients with a follow‐up at 1 year or more, functional complaints were reported more frequently at 1 year than at 3 months after the operation: bile reflux (15
Conclusion
The considerable morbidity and functional consequences of gastrectomy should be considered when counselling individuals with an inherited predisposition to diffuse gastric cancer. Intraoperative frozen‐section examination is recommended to remove all risk‐bearing gastric mucosa.
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