Founded in 1993
  Year: 2000 | Volume: 8 | Issue: 3 | Pages: 91-94
  Original Article
  TOTAL GASTRECTOMY AND ITS EARLY POSTOPERATIVE COMPLICATIONS IN GASTRIC CANCER
Nikola BUDISIN, Ivan MAJDEVAC, Milan BREBERINA, Branimir GUDURIC
  DOI:
  Abstract:
  Background: The study shows operative results and complications occuring in the first 30 days after total gastrectomy because of stomach cancer.
Materials and Methods: Retrograde analysis was performed using medical documentation and histologic findings of 76 patients after total gastrectomy done between 1990 and 1997. Mortality and postoperative complications were analysed. Complications were sorted as specific and non-specific. All operations were done either for intestinal gastric cancer located in proximal stomach or for diffuse stomach cancer. All anastomoses were sewn by hand. Eight surgeons were performing the operations.
Results: There were 43 male and 33 female patients. Postoperative mortality was 14.4%. Most frequent complications were: dehiscence of oesophago-jejuno anastomosis, which happened in 15.8% of operated patients, postoperative temperature without apparent infection in 5.2%, thrombophebitis in 5.2%. Pneumothorax with a frequency of 3.9%, hepatic necrosis in one patient 1.3%, and perforation of jejunal loop with nasogastric tube in 1.3%, which all ended fatally contributed to the relatively high mortality. Mean postoperative intrahospital treatment lasted 12.3 days. Dehiscence of oesophagoentero-anastomosis, resulted in generalised peritonitis in 66.6%. Six patients succumbed as a consequence, while two survived with subphrenic and intraansal abscesses. Pneumothorax in combination with total gastrectomy was always fatal.
Conclusion: Routine use of stapling surgery, sub-specialisation in surgery and better early intensive care monitoring and treatment could improve mortality rate.
  Key words: Gastric cancer; Surgery; Resection; Gastrectomy; Complications; Mortality
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Founder, owner and publisher: Oncology Institute of Vojvodina, Serbia
Online since 1997 (Abstracts only); 2000 (Abstracts and Full text)
ISSN: 0354-7310 eISSN: 1450-9520