BACKGROUND: A total gastrectomy is considered a procedure with a high level of complexity, has high complication rates, both local and general, because patients are mostly with clinical conditions and nutritional compromised by disease. AIM: To analyse the results and complications of the total gastrectomy in gastric cancer in the period from 1972 to 2007. METHODS: Were reviewed the medical records of 300 patients with gastric adenocarcinoma, divided into two periods: from 1972 to 1992 - comprising 108 patients (36%) and from 1993 to 2007 - comprising 192 patients (64%). They were 67.3% males, 70.7% whites, with ages ranging from 25 to 86 years (mean 63.4 years). The lesions were located in cardia - 40 cases (13.3%), gastric fundus - 83 cases (27.6%), gastric body - 77 cases (25.6%); plastic linitis- 45 cases (15%); gastric stump - 33 cases (11%) and antrum and body gastric - 22 cases (7.3%). A total gastrectomy with extended lymphadenectomy to level D2 was performed in 246 cases (82%). RESULTS: The reconstruction technique used was the esophagus-jejunal anastomosis end-to-side Roux-en-Y in 257 patients (86.7%). The general complications in the period from 1972 to 1992 totalized 47 cases (43.5%), mainly involving the respiratory (28 cases - 25.9%) and urinary tract (10 cases - 9.2%). In the period from 1993 to 2007 amounted to 48 cases (25%), mainly respiratory complications (27 cases - 14%), followed by urinary (12 cases - 6.2%). The local complications from 1972 to 1992 totalized 45 cases (30.8%) and in the period from 1993 to 2007 amounted to 28 cases (14.5%), being the most frequent the digestive fistulas. The operative mortality through 30 days was 18 cases (6%), while in the period from 1972 to 92 a total of 12 cases (11.1%) and in the period from 1993 to 2007 were 7 cases (3.6%). CONCLUSIONS: Total gastrectomy is a procedure that requires a skilled surgeon, his team, using an improved surgical technique to minimize postoperative complications. The postoperative complications requiring care in controlling infections, airway and nutritional care, reducing mortality, increasing survival and contributing to quality of life of patients.
Gastric adenocarcinoma; Total gastrectomy; Complications; Digestive fistula
