Factors influencing the development of small intestinal obstruction following gastrectomy for early gastric cancer

BACKGROUND/AIMS: The factors influencing the development of small intestinal obstruction following gastrectomy for early gastric cancer are controversial. METHODOLOGY: Univariate and multivariate analyses were carried out using data from 136 patients with early gastric cancer who underwent gastrectomy. The mean follow-up interval was 5 years and 11 months. RESULTS: Of these 136 patients, 15(11.0%) presented mechanical obstruction in the small intestine postoperatively. Re-operation for repair of the related ileus was required in 8 patients, 4 of whom had been treated with total gastrectomy, 7 with resection of the greater omentum, and 3 with concomitant resection of other organs. Development of an obstruction was not related to wide resectional procedures such as extended lymph node dissection or combined resection of other organs, but was significantly correlated with total gastrectomy and resection of the greater omentum (p < 0.05). In multivariate logistic regression analysis, total gastrectomy proved to be a significant risk factor related to the development of small intestinal obstruction. CONCLUSIONS: In patients with early gastric cancer, total gastrectomy should not be attempted to prevent postoperative ileus and to ensure a fairly sustained quality of life.