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A Retrospective Study of Clinicopathological Profiles of Proximal Gastrectomy Vs Distal Gastrectomy in Carcinoma Stomach and Its Incidence in our Population

Dr Magesh kumar J, Dr V Naveen Kumar, Dr P Suresh babu, Dr K S Ravishankar, India

Adenocarcinoma of stomach has been a leading cause of cancer death worldwide through most of the twentieth century. The incidence of this disease has decreased in many parts of the world, principally because of the change in diet, food preparation and other environmental factors. Due to lack of well defined risk factors and specific symptomatology have contributed to the late presentation of this disease in our country. In Japan, where gastric cancer is endemic, general population was screened as a whole and was diagnosed at an early stage, which is reflected in the excellent 50% five year survival rate.
Though the incidence of gastric carcinoma has decreased dramatically over the last century the decline has been limited to the cancers below the gastric cardia. The number of newly diagnosed patients with proximal gastric and gastroesophageal adenocarcinoma has markedly increased since the mid 1980's. In this study we have compared the clinicopathological profiles of patients with proximal and distal gastric adenocarcinoma. It is a retrospective observational study done on patients with gastric adenocarcinoma who were admitted at the Department of General Surgery of Sree Balaji Medical College And Hospital, Chennai during the period between May 2016 to April 2018.
We included all the patients with adenocarcinoma of stomach and excluded other malignancies of stomach. A total of 65 cases were taken up and factors like presenting illness, past history of ulcer treatment, gastric surgery and personal history along with Upper GI endoscopies , biopsies, CT abdomen and also USG of abdomen were obtained and studied. In our study we found that the incidence of distal gastric adenocarcinoma is more frequent in our population than the proximal lesions, which is of more incidence in Western Hemisphere.
We also found that the Males outnumbered the females, low socioeconomic strata were affected more, proximal lesions showed dysphagia than the distal ones and hepatomegaly were prominent in proximal than in distal. Proximal tumours have hepatic metastasis at presentation more frequently than the distal tumours; this was also statistically significant in our study. The diagnosed patients were advised to undergo a total or subtotal gastrectomy. CA stomach is a very well treatable disease when diagnosed earlier where the screening plays an important role and must be made aware of it in developing countries like India.

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