ABSTRACT

Aims:

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.

Methods:

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.

Results:

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.

Conclusion:

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.