SURGICAL TREATMENT FOR GASTRIC CANCER ASSOCIATED WITH CARDIOAORTIC DISEASE

Twenty cases of gastric cancer associated with cardioaortic disease are retrospectively studied on. There were 16 men and 4 women, with a mean age of 65, ranging from 37 to 78 years old. Cardioaortic diseases included aortic aneurysm in 10 cases, IHD in 5 cases, and congenital and valvular disease in 5 cases. Thirteen cases were diagnosed as having a gastric cancer before admission and the remaining 7 cases, after admission. Of the 7 cases, 4, cases of early gastric cancer were diagnosed by endoscopy or fluoroscopy of the stomach, and 3 cases of advanced cancer presented with anemia which gave a clue for the diagnosis. There was a case of cardioaortic disease in which gastrointestinal examination was performed because of positive result for occult blood in stools. For operative patients with cardioaortic disease, we should always entertain a probable coexistence of other disease, especially gastrointestinal lesion, in preoperative examination and postoperative follow-up. If some other gastrointestinal lesion in detected, a two-step approach is generally recommended when the operation for gastric cancer precedes that for cardioaoric disease, though it is reversed, if the cardioaortic disease is in a critical stage such as imminent rupture of an aortic aneurysm.