Profile of 150 cases of carcinoma stomach in Tirunelveli Medical College Hospital

Swarnalatha, A (2009) Profile of 150 cases of carcinoma stomach in Tirunelveli Medical College Hospital. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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INTRODUCTION: Carcinoma stomach is one of the leading causes of morbidity and mortality accounting for 12% of deaths. There has been a decline in its incidence since 1930. Even though the incidence of distal gastric cancer is decreasing in western countries, incidence of proximal gastric cancers continue to increase. The overall 5-year survival rates ranging from 53% in Japan to 10% in Eastern Europe. A better outcome is obtained in Japan due to an active screening programme resulting in earlier diagnosis and an aggressive surgical approach. The combination of chemoradiation therapy and curative resection increases disease free and overall survival duration which has led to recommend multimodality treatment in patient with systemic disease. Inspite of this multimodality treatment the morbidity and mortality continues to be high. AIMS OF THE STUDY: This study was mainly to analyse cases of carcinoma stomach in our region which commonly present to the general surgeon in the department of general surgery , Tirunelveli Medical College Hospital, Tirunelveli. The study was conducted in the following principles. • To study the anatomical location of growth with respect to age and gender distribution. • To study the Etiology & Risk factors with respect to anatomical location. • Study of H.Pylori association with carcinoma stomach. • To study the sensitivity and specificity of various investigation modalities used. • To study the Histopathological variety in relation to the site of growth. • To study the mortality and morbidity rate with reference to treatment modality. MATERIALS AND METHODS: This study was conducted in the general surgery department , Tirunelveli Medical College Hospital,Tirunelveli for a period of 30 months, from June 2006 to November 2008. • 150 Cases of Carcinoma stomach were studied during this period. • Details of 150 patients with Adenocarcinoma were retrieved and follow up of these patients was done with the surgical treatment modalities used and its outcome and survival. • Cancer recurrence after surgery and cancers after GJ for peptic ulcer disease were excluded from this study. • Age, gender, predisposing factors, clinical presentation and surgical treatment modalities used were recorded in a prestructured proforma. • The site of the stomach tumours was recognized as involving one of the four sites. Namely: 1. OG Junction 2. Proximal Stomach (Cardia & Fundus), 3. Body, 4. Antrum. • Only those cases which received some form of surgical treatment were included in the study. • Association of H.Pylori with gastric cancer study was carried out in eleven patients of histologically proved gastric carcinoma. • The WHO classification of HPE report was combined with Lauren’s HPE type in order to study the Histopalthology type in relation to tumour location. DATA ANALYSIS: The Commonest abdominal malignancy in our region is CA stomach. • The Common site of involvement in CA stomach is Pyloric Antrum constituting 117 out of 150 cases. • This was in concordence with the study of cherian et al (2007), Sivaraman et al. • This study, is contradictory to the rising incidence of AdenoCA of proximal growth in the West, Iran, Sweden & Kerala. CONCLUSION: The causes of Distal stomach cancer continues to be commoner than proximal cancers among Indians. The Etiology of carcinoma stomach tends to be different etiology in both proximal and distal cancers. H.Pylori has a 45 .5% association of ca stomach and it is mostly associated with distal growths. Endoscopy has a high sensitivity in detecting all subsite growths but least sensitivity in detecting early cancers. Most cases present with stage 4 disease which shows absence of screening of this disease. Curative subtotal and distal gastrectomy is associated with good quality of life whenever the tumour is operable. Mortality is due to increase in duration of surgery and associated co-marbid illness

Item Type: Thesis (Masters)
Uncontrolled Keywords: carcinoma stomach ; Profile ; 150 cases ; Tirunelveli Medical College Hospital.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 09 Jun 2018 17:15
Last Modified: 13 Jan 2020 14:12

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