Postoperative results of left upper abdominal evisceration for advanced gastric cancer

Background/Aims: In spite of the improvement of surgical techniques, the pr ognosis of patients with advanced gastric cancer still remains poor. With t he aim of achieving en bloc resection of primary tumor, peritoneal dissemin ation on the greater omentum and lymph node metastasis, left upper abdomina l evisceration (LUAE) was performed. for 75 patients. In this report, we in vestigated the prognostic difference between the LUAE group and standard ga strectomy (total gastrectomy + pancreatosplenectomy). Methodology: In the LUAE group, total gastrectomy was performed with the en , bloc resection of the transverse colon, pancreas body and tail, spleen an d left adrenal gland. In addition, omental bursa, covering retroperitoneum and pancreas body and tail was resected in combination with greater omentum , transverse mesocolon, and lesser omentum. Results: There were 3 (4.1%) postoperative death in the LUAE group, and 2 ( 1.7%) in the control group. However, there was no statistical difference in the incidence of postoperative complications between these 2 groups. The o verall 5-year survival rates of the LUAE and control groups were 33% and 39 %, respectively. There was no statistical survival difference between these 2 groups. Survival difference between the LUAE and control group was not f ound in terms of tumor location, wall invasion, lymph node status, peritone al dissemination, and macroscopic type. Conclusions: From these results, LUAE cannot improve the survival of patien ts with advanced gastric cancer. Consequently, LUAE should be indicated for T4 tumors, which directly invade into the transverse colon.