Total gastrectomy: is the early postoperative morbidity and mortality influenced by the choice of surgical procedure?

From 1973 to 1982, seventy-two total gastrectomies were performed. The Siewert-Peiper gastric replacement procedure was used in 48 cases, while the Rou-xen-Y method was performed in 24 cases. Retrospective analysis showed no significant statistical difference between the 2 methods with regard to postoperative morbidity and mortality. There was an overall mortality rate of 11% and a morbidity rate of 45% (10% anastomosis breakdown, 27% pulmonary complications, 1% bowel obstruction, 7% other complications). As the Roux-en-Y anastomosis is technically easier to perform compared to the Siewert-Peiper gastric replacement and as the functional results from the literature are similar, we will, in the future, favor using the Roux-en-Y method in our department.