Gastric Malignancy In Khartoum Teaching Hospital

Abstract

This prospective descriptive study was conducted to determine the clinical presentation, modes of investigation, management and outcome of gastric malignancy in 92 patients, over the period from January 2001 to December 2003, in a general surgical unit in Khartoum Teaching Hospital (KTH). The peak incidence of gastric malignancy was in the seventh and eighth decades 27 (29.3%) and 23 (25%) respectively and most of them were males 64 (69.6%). The incidence of the disease was commoner in Central Sudan (44.6%). The most frequent mode of presentation was epigastric pain (90.2%), loss of weight (90.2%), anorexia (71.2%), pallor (53%) and abdominal mass (43%). The cardia was the main site to be affected (41.3%). Histologically adenocarcinoma was by far the most frequent (94.1%), well differentiated adeno-carcinoma and intestinal type were the commonest varieties (312%) and (17.4%) respectively. Most of the patients had group O +ve blood (50%). Upper GI endoscopy had (88%) accuracy and barium radiology had an accuracy of (87%). Almost all the patients presented with locally advanced stage disease. Palliative resection was attempted in 44(67.6%) patients with survival duration of 9.9 months compared with 5 month for those who had no resection (n=21). Morbidity rate was significantly higher in the resected group compared with nonresected group (18.8%) and (4.2%) respectively, while the mortality rate was slightly higher (15.9%) and (14.6%) respectively. Patients satisfaction was significantly better in the resected group. In conclusion none of our patients had an early curable gastric malignancy. Palliative resection lengthened the survival duration and improved the quality of life. Precise selection of patients who may benefit from palliative resection is of paramount importance