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Gastric exclusion for unresectable gastric cancer.

BACKGROUND/AIMS
Conventional gastrojejunostomy is sometimes performed for unresectable gastric cancer, but it is not fully effective. To improve the patient's quality of life, we performed gastric exclusion.


METHODOLOGY
Twenty-seven patients who received gastrojejunostomy (11 conventional, 16 gastric exclusion) were retrospectively examined as to post-operative quality of life and outcome.


RESULTS
No stomal strictures were observed, and gastrointestinal bleeding was significantly reduced in the gastric exclusion group. These advantages enabled the gastric exclusion group to achieve better quality of life, as indicated by longer oral intake (244 days vs. 98 days) and home stay (211 days vs. 91 days). The prognosis also improved. The 50% survival period in the gastric exclusion group was 229 days, whereas, that of the conventional gastrojejunostomy group was 131 days.


CONCLUSIONS
The quality of life and prognosis of the gastric exclusion group significantly improved, and we believe that the improvement of the quality of life yielded a better prognosis. We recommend gastric exclusion as a standard procedure for unresectable gastric cancer.