Total Gastrectomy and Reconstruction Procedures in Curative Therapy of Gastric Carcinoma
Dr. Hüseyin ALTUN, Dr . İbrahim AYDIN, Dr. Selim SARI, Dr. Aslan KAYGUSUZ
S.S.K. istanbul Hastanesi, 2. Cerrahi Kliniği, İSTANBUL
Total gastrectomy was performed on 48 patients with gastric carcinoma between 1990 and 1994. These cases are studied retrospectively for indication, complications, reconstruction procedures, morbidity and mortality. 8 of 48 patients were women and 40 were men. All the patients were operated in elective conditions except one.
Total gastrectomy + gastrojejunostomy + Braun anastomosis was performed on 29 patients. Stapler was used in 5 patients. In two patients with stapled anastomosis stricture developed. Strictures are treated with balloon dilatation postoperatively. Three patients died due to ARDS in the first week. No additional complications occured during observation.
The pathological diagnosis of 41 patients was adenocarcinoma and 7 patients was lymphoma and there was no residual barcinoma on the line of anastomosis.
The little tumors occupied on the antrum and corpus of the stomach are treated with subtotal gastrectomy, but if there is extension on the line of minor curvatura then total gastrectomy must be done. The reconstruction procedure is related with the surgeon's experience, our choice is eusophagojejunostomy and Braun anastomosis and we prefer to make the anastomosis manually.
Keywords: Gastric carcinoma, Total gastrectomy