Document Detail

Postoperative complications and functional results after subtotal gastrectomy with Billroth II reconstruction for primary gastric cancer.
MedLine Citation:
PMID:  17404848     Owner:  NLM     Status:  MEDLINE    
Subtotal gastrectomy is considered the preferred treatment for gastric cancer with antral location. The aim of this study was to assess the incidence of early postoperative complications and late functional results in patients who underwent subtotal gastrectomy with Billroth II reconstruction for primary gastric adenocarcinoma. The results of 310 patients were analyzed with regard to postoperative complications and death rates. Functional results as they relate to the gastric resection were evaluated in 195 disease-free patients. Of the 310 patients, 77 developed postoperative general and surgical complications (24.8%) and 13 consequently died (in-hospital mortality: 4.2%). Although infrequent (6 cases, 1.9%), anastomotic leak was the most serious complication (4 cases died during the postoperative phase). Considering functional results, weight loss continued for the first trimester after surgery, after which it stabilized. Loss of appetite was rarely observed; early after the operation the majority of patients were consuming a normal diet and regularly consumed less than five meals per day (83.6%). Dumping syndrome was uncommon and usually resolved within one year (12.3% at three months, 9.5% after one year, 5.2% after two years). On the other hand, postprandial abdominal fullness was frequently observed (43.1% at three months, 36.1% after one year, 21.3% after three years, and 16.5% after five years). Billroth II reconstruction after subtotal gastrectomy is associated with a limited risk of anastomotic complications. Anastomotic leak, although infrequent, is a life-threatening complaint and requires prompt recognition and aggressive surgical treatment. The incidence of late complications was low and the majority of patients recovered from them within one year after surgery, although the occurrence of postprandial abdominal fullness was not completely irrelevant.
Corrado Pedrazzani; Daniele Marrelli; Bernardino Rampone; Alfonso De Stefano; Giovanni Corso; Giuseppe Fotia; Enrico Pinto; Franco Roviello
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-04-03
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  52     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-06-28     Completed Date:  2007-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1757-63     Citation Subset:  AIM; IM    
Department of Human Pathology and Oncology, Unit of Surgical Oncology, University of Siena, Siena, Italy.
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MeSH Terms
Adenocarcinoma / mortality,  surgery*
Aged, 80 and over
Dumping Syndrome / etiology
Middle Aged
Postoperative Complications
Stomach Neoplasms / mortality,  surgery*

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