| Objective: To probe the value of ttotal gastrectomy and the suitable reconstruction method and to summarize the clinical experience of the operative therapy.Method: A retrospective study was done on 91 cases (at age over 60 years old) with total gastrectomy in No.2 hospital of Jilin University from January 1997 to December 2006 to analyze the features of the gastric cancer in elderly, the indication of total gastrectomy, the operative mortality rate, the postoperative complications rate, the perioperative management, the selection of reconstruction methods and the application of stapler.Result: 36.11% of gastrectomy in the elderly patients was the total gastrectomy, and the number is increasing, it has increased 18.04% in the past five years. The operative mortality rate was 5.49%(5/91), the postoperative complication rate was 25.27%(23/91), the anastomotic leakage rate was 3.29%(3/91), the total one year-survival rate was 42.68%(35/82), the one year-survival rate was 63.3%( 31/49) for radical resection and 12.1%(4/33) for palliative resection. Double Braun anastomosis and jejunum constriction is better than Longmire's reconstruction method. In reducing the postoperative complication rate and the operation time there were significant difference between the stapler and the manual anastomosis.Conclusion: It is secure to perform the total gastrectomy for gastriccancer in elderly. The total gastrectomy can significantly improved the life quality of the elderly patients with gastric cancer. Extensive lymphadenectomy can significantly prolong the life span . The key to reduce the mortality and the postoperative complication rate is the individual perioperative management , the application of stapler, the reasonable selection of reconstruction method, the skill and exper- ience of the surgeon.
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