ABSTRACT

The aims of this study were to scrutinize the immediate post-operative complications encountered after different subtotal gastrectomy procedures and to identify the safest surgical variant.

In this retrospective, observational study data of 54 patients, of whom 32 were male and 22 were female, with a mean age of 65.7 years diagnosed with gastric carcinoma underwent a variant of subtotal gastrectomy in the Surgery Department of the Bucharest Clinical Emergency Hospital between January 2010 and December 2012 were recorded. The categorical statistical data was obtained with Chi-square method using GraphPad Prism and statistical significance was set at a p-value <0.05.

A total of 73 immediate post-operative complications were encountered in 23 (41.8%) patients classified into local in 14 (19.2%) patients and general in 59 (80.8%) patients. The most common complication classified as local was leakage found in 5 (6.9%) patients, while the most frequent ones in general complications were secondary anemia presented in 17 (23.3%) patients and pulmonary compromise: pleural effusion in 3 (4.1%) patients. Ten associated surgical procedures were necessary, the most common being omentectomy (30%). Re-operation was deemed imperative in 5 (9.1%) cases , 4 (80%) of which were after Billroth I and 1 (20%) case was subsequent to Roux-en-Y Side-End Esophagojejunostomy. Three (5.6%) deaths were reported, 2 (66.7%) of which occurred after Roux-en-Y Side-End Esophagojejunostomy and 1 (33.3%) after the Billroth I variant.

Billroth I yielded the highest number of complications, both local and general, compared to Hofmeister- Finsterer which generated the lowest number. The same pattern was noted with respect to the length of hospital stay. The longest operative time was recorded in Hofmeister-Finsterer and the shortest in Billroth I. A statistically significant chi-square analysis between the type of subtotal gastrectomy procedure and anastomotic leakage was obtained.

Keywords: Gastrectomy, gastric cancer, post-operative complications