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A Single-Institution Experience

Fabio Pacelli, MD; Valerio Papa, MD; Fausto Rosa, MD; Antonio Pio Tortorelli, MD; Alejandro Martin Sanchez, MD; Marcello Covino, MD; Maurizio Bossola, MD; Giovanni Battista Doglietto, MD

Arch Surg. 2008;143(8):769-775.

Hypothesis  Although total gastrectomy (TG) has been generally accepted as the treatment of choice for upper and middle gastric cancers, some issues are still debated. The objective of this retrospective study was to analyze short- and long-term results of TG (radical and palliative) in a series of 400 patients consecutively admitted to our surgical unit.

Design  Retrospective cohort study.

Setting  Primary and referral hospital care.

Patients  Hospital records of 400 patients who consecutively underwent TG between January 1981 and June 2005 were reviewed.

Main Outcome Measures  Surgical complications and survival.

Results  Three hundred twelve patients underwent radical procedures, and 88 patients underwent palliative procedures. The incidence of postoperative complications was higher among patients who underwent palliative TG (33 of 88 [37.5%]) compared with patients who underwent curative TG (75 of 312 [24.0%]) (P =.01). Mortality was higher among patients who underwent palliative TG (6 of 88 [6.8%]) compared with patients who underwent curative TG (11 of 312 [3.5%]) (P =.18). Five-year survival was 61.8% after curative TG and 12.8% after palliative TG. Ten-year survival was 47.3% after curative TG and 0.0% after palliative TG.

Conclusions  This study among 400 consecutive patients who underwent TG at the same surgical unit shows that this surgical procedure in experienced hands can lead to excellent short- and long-term results.

Author Affiliations: Digestive Surgery Unit, Department of Surgery (Drs Pacelli, Papa, Rosa, Tortorelli, Sanchez, Bossola, and Doglietto), and Department of Emergency Medicine (Dr Covino), Catholic University School of Medicine, Rome, Italy.

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