Objective To discuss the pathogenesis,clinical manifestations,diagnoses and preventive methods on subsequent Wernicke encephalopathy cases of old gastric cancer patients during perioperation.Methods Collected the data of 237 old gastric cancer patients in perioperation from October 1990 to December 2009 hospitalized in the Department of General Surgery,Lanzhou General Hospital Attached to Military Region,PLA.And then retrospectively analysed 7 patents of them who complicated with Wernicke encephalopathy to summarize the clinical manifestation, accessory examination,diagnosis,prevention, and therapy of the Wernicke encephalopathy,and associated factors with its incidence.Results The clinical manifestations of 7 patients included nystagmus （7 cases）,ataxia（4 cases）,brain disorder（6 cases）.Auxiliary examination：4 cases with anemia,7 cases with unusual blood biochemical examination, 5 cases with urinary ketone bodies positive,2 cases with decreasing blood vitamin B1,1 case with unusual skull MRI examination.Five patients were diagnosed before treatment and 2 case were diagnosed by experimental treatment.Finally，4 patents were cured,1 case obviously improved,1 case improved, and 1 case died.And The patients complicated with preoperative hypoproteinemia or pyloric obstruction and postoperative fistula of intestine or gastroplegia syndrome had statistical higher incidence rates of the Wernicke encephalopathy than those without these complications （P＜0.05）.Conclusions The clinical manifestation of the Wernicke encephalopathy have no specificity, it is hard to diagnose,so clinicians should pay attention to it，and combine different ways to diagnose.Improving or preventing complications during perioperative period,and supplementing enough vitamin B are important preventive and therapeutic measures.
Forty-six patients with advanced gastric cancer were investigated. 25 patients were randomized to receive intraperitoneal hyperthermic (43℃) hypotonic perfusion with high dose cis-diamminedichloroplatinum (60-200mg/m2 body surface) and sodium thiosulfate intraveneously (7.5g/m2 body surface). The time of the intraperotineal perfusion was 30 minutes with the total volume of the perfusate of 2500-3000ml. 21 patients were only operated. The sex ,age macro-or microscopic serosal invasion, and histologic type of two groups were similar and comparatible. We found no cancer cell in nine paients with positive intraperitoneal free cancer cell in the treated group. The postoperative 1-year survival rate of patients in the treated group (96.00%) was significantly higher than that of the random control group (48.54%), Ｐ＜0.01. The postoperative 1 1/2year survival rate in the treated group (68.88%) was also higher than that of the control group (40.00%), however, with no significant difference (Ｐ＞0.05). No serious myelosuppression, kindley,liver, and peripheral nerve damage, and other complications were found. The results indicated that this therapy is reasonably safe and could be a prophylactic theapy for the peritoneal recurrence after radical gastrectomy, which should be further investigated.