[Care management of lower gastric tumors at Dakar. Preliminary study of 60 cases].

The aim of this study was to evaluate the short-term results of our therapeutic attitude about the surgical treatment of lower gastric tumours in our departement. It was a prospective study including all patients hospitalized in our department for gastric tumour whose malignancy was strongly presumed by the clinical symptoms, the paraclinical one, the surgical exploration and/or confirmed by histology. Tumours of the cardia were excluded from this study. Laparotomy was carried out among all patients. When the tumour was resecable, we had carried out a lower partial gastrectomy passing at least than five centimeters with the top of the higher limit of the tumour, associated with lymphadenectomy including the first and second relay. This study was undertaken from January 1994 to June 1997 and concerned 39 men and 21 women. Mean age was 57.6 years. The abdominal mass was present in 38.3% of the cases. The histological confirmation for malignancy was obtained in 38.3% of the cases which all were adenocarcinomas. We had proceded to 38% of partial gastrectomy, 54% of gastrojejunostomy and in 8% of the cases no surgical gesture was practised during laparotomy. Morbidity was 13.3% and mortality 21.7%. The average retreat was 12.4 months after partial gastrectomy, 8.3 months after gastrojejunostomy and 3.5 months after laparotomy without gesture. The total rate of surival at one year was 20%. The rate of survival at one year after partial gastrectomy was 39.1%. We recommend partial gastrectomy associated with lymphadenectomy whenever its realization is possible. This surgical attitude associated to early diagnosis could allow a clear improvement of the rate survival in the short and medium term for lower gastric tumors, in our context.