Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário

FAVACHO, Bernard Costa; COSTA, Carleno da Silva; MAGALHÃES, Thamer Costa; ASSUMPÇÃO, Paulo Pimentel de; ISHAK, Geraldo

Artigo

Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário

Gastric neoplasia is a heterogeneous and multifactorial disease and its incidence and mortality vary widely based on geographic location. Approximately 60% of the diagnoses of patients from occidental countries were made on the stages III and IV. The best treatment still is to realize a surgical pro...

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Autor principal:	FAVACHO, Bernard Costa
Outros Autores:	COSTA, Carleno da Silva, MAGALHÃES, Thamer Costa, ASSUMPÇÃO, Paulo Pimentel de, ISHAK, Geraldo
Grau:	Artigo
Idioma:	por
Publicado em:	2014
Assuntos:	Adenocarcinoma Câncer gástrico Carcinoma gástrico Neoplasias gástricas Aparelho digestivo Cirurgia Sobrevida Gastric cancer Surgery Survival
Acesso em linha:	http://repositorio.ufpa.br/jspui/handle/2011/5910 http://dx.doi.org/10.1590/S0102-67202013000400004

id	ir-2011-5910
recordtype	dspace
spelling	ir-2011-59102020-01-22T16:21:56Z Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário T4b gastric carcinoma: 12 years of experience at an university hospital FAVACHO, Bernard Costa COSTA, Carleno da Silva MAGALHÃES, Thamer Costa ASSUMPÇÃO, Paulo Pimentel de ISHAK, Geraldo Adenocarcinoma Câncer gástrico Carcinoma gástrico Neoplasias gástricas Aparelho digestivo Cirurgia Sobrevida Gastric cancer Surgery Survival Gastric neoplasia is a heterogeneous and multifactorial disease and its incidence and mortality vary widely based on geographic location. Approximately 60% of the diagnoses of patients from occidental countries were made on the stages III and IV. The best treatment still is to realize a surgical procedure. AIM: Identify the epidemiological aspects of the patients diagnosed with T4b gastric adenocarcinoma. METHODS: The study was observational, transversal and retrospective; it was also based on secondary sources from patients diagnosed with T4b gastric adenocarcinoma, through pathologic stages. A total of 815 charts were analyzed and 27 patients studied. The variables were: demographic aspects, main symptoms, risk factors, access to health system, surgical aspects, morbidity, mortality and survival. RESULTS: Were included 22 men (81,5%) and five woman (18,5%), in the age group between 38 and 87 years old - median age of 58. The time, in months, to access the health system varied from one to 120, average of 12,5 months. The most prevalent signs and symptoms were: weight loss 23 (85,2%), epigastric pain 22 (81,5%), vomit 16 (59,3%) and gastric fullness 12 (44,4%). The frequency of the affected adjacent body structures was: pancreas 8 (29,6%), liver 7 (25,9%), transverse colon 6 (22,2%), small intestine 6 (22,2%), mesocolon 3 (11,1%), spleen 1 (3,7%) and gallbladder 1 (3,7%). Postoperative morbidity occurred in 51, 85% of the patients. There were a significative association between surgical mortality and the occurrence of fistula/ dehiscence, septic shock and bleeding. The survival rate after six months was 63,27%. CONCLUSION: The mean time between onset of symptoms and access to specialized health services was high. More than half of the patients had postoperative morbidities. Patients who had fistula / dehiscence, bleeding and septic shock were significantly associated with surgical mortality. The survival rate after six months was 63.27%. A neoplasia gástrica é doença heterogênea e multifatorial, com incidência e mortalidade variando geograficamente. Aproximadamente 60% dos diagnósticos em pacientes de países ocidentais ocorrem nos estádios III ou IV. Nestes doentes, o melhor tratamento consiste na realização de procedimento cirúrgico. OBJETIVO: Identificar os aspectos epidemiológicos de pacientes diagnosticados com adenocarcinoma gástrico T4b. MÉTODOS: Estudo observacional, transversal, retrospectivo, de fonte secundária, dos pacientes diagnosticados com adenocarcinoma gástrico T4b através de estadiamento patológico. Foram analisados 815 prontuários, sendo 27 pacientes estudados. As variáveis investigadas foram: aspectos demográficos, principais queixas, fatores de risco, acesso ao serviço de saúde, aspectos cirúrgicos, morbidade, mortalidade e sobrevida. RESULTADOS: Vinte e dois eram homens (81,5%) e cinco mulheres (18,5%) com idade variando de 38 a 87 e média de 58,78 anos. O tempo de acesso ao serviço, em meses, variou de 1 a 120, com média de 12,5. Os sinais e sintomas mais prevalentes foram: perda de peso 23 (85,2%), epigastralgia 22 (81,5%), vômitos 16 (59,3%) e plenitude gástrica 12 (44,4%). A frequência de acometimento das estruturas adjacentes foi: pâncreas oito (29,6%), fígado sete (25,9%), cólon transverso seis (22,2%), intestino delgado seis (22,2%), mesocólon três (11,1%), baço um (3,7%) e vesícula biliar um (3,7%). Morbidades pós-operatórias ocorreram em 51,85% dos pacientes. Houve associação significativa entre mortalidade cirúrgica e ocorrência de fístula/deiscência, choque séptico e sangramento. A sobrevida ao final de seis meses foi de 63,27%. CONCLUSÃO: A média do tempo entre início dos sintomas e acesso ao serviço de saúde especializado foi elevada. Mais da metade dos pacientes apresentaram morbidades pós-operatórias. Os pacientes que apresentaram fístula/deiscência, sangramentos e choque séptico tiveram associação significativa com mortalidade cirúrgica. A sobrevida ao final de seis meses foi de 63,27%. UFPA - Universidade Federal do Pará 2014-10-22T12:07:56Z 2014-10-22T12:07:56Z 2013-12 Artigo de Periódico FAVACHO, Bernard Costa et al. Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), São Paulo, v. 26, n. 4, p. 268-273, nov./dez. 2013. DOI: http://dx.doi.org/10.1590/S0102-67202013000400004. Disponível em: http://repositorio.ufpa.br/jspui/handle/2011/5910. Acesso em:. 2317-6326 http://repositorio.ufpa.br/jspui/handle/2011/5910 http://dx.doi.org/10.1590/S0102-67202013000400004 por ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) Acesso Aberto application/pdf application/pdf http://ref.scielo.org/x5pjsv
institution	Repositório Institucional - Universidade Federal do Pará
collection	RI-UFPA
language	por
topic	Adenocarcinoma Câncer gástrico Carcinoma gástrico Neoplasias gástricas Aparelho digestivo Cirurgia Sobrevida Gastric cancer Surgery Survival
spellingShingle	Adenocarcinoma Câncer gástrico Carcinoma gástrico Neoplasias gástricas Aparelho digestivo Cirurgia Sobrevida Gastric cancer Surgery Survival FAVACHO, Bernard Costa Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
topic_facet	Adenocarcinoma Câncer gástrico Carcinoma gástrico Neoplasias gástricas Aparelho digestivo Cirurgia Sobrevida Gastric cancer Surgery Survival
description	Gastric neoplasia is a heterogeneous and multifactorial disease and its incidence and mortality vary widely based on geographic location. Approximately 60% of the diagnoses of patients from occidental countries were made on the stages III and IV. The best treatment still is to realize a surgical procedure. AIM: Identify the epidemiological aspects of the patients diagnosed with T4b gastric adenocarcinoma. METHODS: The study was observational, transversal and retrospective; it was also based on secondary sources from patients diagnosed with T4b gastric adenocarcinoma, through pathologic stages. A total of 815 charts were analyzed and 27 patients studied. The variables were: demographic aspects, main symptoms, risk factors, access to health system, surgical aspects, morbidity, mortality and survival. RESULTS: Were included 22 men (81,5%) and five woman (18,5%), in the age group between 38 and 87 years old - median age of 58. The time, in months, to access the health system varied from one to 120, average of 12,5 months. The most prevalent signs and symptoms were: weight loss 23 (85,2%), epigastric pain 22 (81,5%), vomit 16 (59,3%) and gastric fullness 12 (44,4%). The frequency of the affected adjacent body structures was: pancreas 8 (29,6%), liver 7 (25,9%), transverse colon 6 (22,2%), small intestine 6 (22,2%), mesocolon 3 (11,1%), spleen 1 (3,7%) and gallbladder 1 (3,7%). Postoperative morbidity occurred in 51, 85% of the patients. There were a significative association between surgical mortality and the occurrence of fistula/ dehiscence, septic shock and bleeding. The survival rate after six months was 63,27%. CONCLUSION: The mean time between onset of symptoms and access to specialized health services was high. More than half of the patients had postoperative morbidities. Patients who had fistula / dehiscence, bleeding and septic shock were significantly associated with surgical mortality. The survival rate after six months was 63.27%.
format	Artigo
author	FAVACHO, Bernard Costa
author2	COSTA, Carleno da Silva MAGALHÃES, Thamer Costa ASSUMPÇÃO, Paulo Pimentel de ISHAK, Geraldo
author2Str	COSTA, Carleno da Silva MAGALHÃES, Thamer Costa ASSUMPÇÃO, Paulo Pimentel de ISHAK, Geraldo
title	Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
title_short	Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
title_full	Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
title_fullStr	Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
title_full_unstemmed	Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário
title_sort	adenocarcinoma gástrico t4b: experiência de 12 anos em hospital universitário
publishDate	2014
url	http://repositorio.ufpa.br/jspui/handle/2011/5910 http://dx.doi.org/10.1590/S0102-67202013000400004
_version_	1787148541684088832
score	11.653393

Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário

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