Total gastrectomy for stomach cancer at Hospital Universitario San Jose, Popayán. Retrospective cohort study of 16 years

Abstract

Objective: To describe clinical, histological outcomes and postoperative surgical complications of patients who were under total gastrectomy for gastric cancer at the Hospital Universitario San José (HUSJ) of Popayan in the period from 1990 to 2006. Methods: Retrospective cohort study. We included patients with history of total gastrectomy secondary to gastric cancer. Patients were characterized clinically and demographically according preoperative state. Data related to the surgical technique, diagnosis and clinical TNM stage were described. Early mortality (less than thirty days), occurrence of fistula or abdominal sepsis during hospitalization and length of hospital stay was calculated. The length of hospital stay until discharge was analyzed graphically. Results: During the study period 69 procedures were performed. 73% of patients were male and the mean age was 62 years. 97% of the subjects (60 patients) had advanced gastric cancer, 75% had adenocarcinoma of intestinal type and 15% of diffuse type. Postoperative complications occurred in 20.2%, including requirement of surgical re-intervention (10%), abdominal fistula (7.2%) and abdominal sepsis (3%). The 30-day mortality was 4.3% (95% CI (1.1 to 11.3)). Discussion: Demographic and clinical patterns of the patients studied do not differ from those reported in literature worldwide. Frequencies of complications and mortality found in this study are consistent with those from larger studies. Given the lateness of diagnosis, actions of prevention and screening for early detection of gastric cancer should be carried out in our country to increase the chances of curative treatment.

Keywords

• Neoplasias Gástricas, Gastrectomía, Colombia