Objective: To evaluate indications and approaches of re-surgical treatment for postoperative anastomotic recurrence of adenocarcinoma of the gastric cardia.
Method: Clinical date on 23 patients who had received re-surgical treatment for postoperative anastomotic recurrence of adenocarcinoma of the gastric cardia were analyzed retrospectively.
Results: The rate of tumor resection, incidence of complications, and mortality in the patients were 69.6%, 17.4% and 8.7% respectively. The percentage of patients with pleural and peritoneal adhesion was 87.0%. The mean survival time of the patients with tumors resected was 15.0 months, much longer than 4.1 months of the patients who underwent exploration (P < 0.05). The mean survival time of the patients with no lymph node metastasis and those with lymph node metastasis was 21.3 months and 10.2 months respectively (P > 0.05). The mean survival time of the patients with radical resection was 15.8 months, and that of the patients with palliative resection was 13.3 months (P > 0.05).
Conclusions: Because of extensive pleural and peritoneal adhesion as well as re-building of the alimentary tract, the operation for anastomotic recurrence of adenocarcinoma of the gastric cardia is difficult and the mortality is high. Moreover, the prognosis of the patients with adenocarcinoma of the gastric cardia is poor. Indications for re-surgical treatment should be strictly selected. Operative approach should depend on the stage of disease.