Upon joining the study, the patient must understand and accept the trial procedures and sign an informed consent form.

Eligibility includes being over 18 years of age, having a diagnosis of gastric cancer with the possibility of total gastrectomy, and undergoing surgery at a participating hospital center.

During the surgery, a fibrin-based adhesive called TISSEEL is applied. This adhesive contains substances such as aprotinin, human fibrinogen, calcium chloride dihydrate, human thrombin, and human coagulation factor xiii.

The adhesive is used to reduce the risk of dehiscence, which is a complication where the surgical connection between the esophagus and the jejunum may come apart.

After surgery, the patient is monitored for signs of suture dehiscence within the first seven days. This is done using clinical and radiological assessments.

The type of surgical connection (anastomosis) performed is recorded, whether manual or mechanical.

Blood tests are conducted on days 0, 1, 3, 5, and 7 after surgery to measure levels of leukocytes, procalcitonin, and C-reactive protein.

Amylase levels in drainage are checked on days 1, 3, 5, and 7, or until the drainage is removed.

A CT scan with oral contrast may be performed, and findings are evaluated using the Goense score.

Any postoperative complications are classified using the Clavien-Dindo classification system.

The need for urgent surgical reintervention is assessed if complications arise.

The date of hospital discharge is recorded.

The patient is monitored for readmissions at 30 and 90 days post-surgery.

In-hospital and 90-day mortality rates are also tracked as part of the study outcomes.