Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cancer

被引:56
作者
Gil-Rendo A. [1 ]
Hernández-Lizoain J.L. [1 ]
Martínez-Regueira F. [1 ]
Sierra Martínez A. [1 ]
Rotellar Sastre F. [1 ]
Delgado M.C. [1 ]
Azcarate V.V. [1 ]
Idoate C.P. [1 ]
Álvarez-Cienfuegos J. [1 ]
机构
[1] General Surgery Department, Clinica Universitaria of Navarra, Pamplona, 31008 Pamplona Navarra
关键词
Gastric cancer; Risk factors for complications; Surgical morbidity and mortality;
D O I
10.1007/s12094-006-0182-x
中图分类号
学科分类号
摘要
Introduction: The purpose of this study is to analyze postoperative morbidity and mortality of patients operated on for gastric cancer in a single institution during the last twenty years, and to define risk factors for complications. Material and methods: A retrospective study was carried out on 434 patients who underwent gastrectomy for gastric cancer between January 1983 and December 2002. Analysis of main medical and surgical complications and analysis of morbidity risk factors. Results: Overall morbidity and mortality rates were 38.4% and 2.7% respectively. The most frequent complications were pneumonia (13%) and intra-abdominal abcesses (12%). The main cause of death was anastomotic dehiscence with abdominal sepsis. The last ten years mortality rate dropped from 4.7% to 0.8%. Risk factors for complications were gender (male, p = 0.01) and resection of spleen (p = 0.02) or pancreas (p = 0.002). A significantly lesser rate of complications was found in patients who had underwent gastrectomy during the previous five years (p = 0.001) or with tumors located in the lower third of the stomach (p = 0.01). Conclusion: Morbidity of gastrectomy for gastric cancer in our institution is still high but mortality has decreased significantly over the last ten years due to the specialization of the hospital and the surgical team. The main risk factor for complications was pancreatosplenectomy in the multivariate analysis. © FESEO 2006.
引用
收藏
页码:354 / 361
页数:7
相关论文
共 32 条
[1]  
So J.B., Yam A., Cheah W.K., Kum C.K., Goh P.M., Risk factors related to operative mortality and morbidity in patients undergoing emergency gastrectomy, Br J Surg, 87, 12, pp. 1702-1707, (2000)
[2]  
Maruyama K., Sasako M., Kinoshita T., Et al., Should systematic lymph node dissection be recommended for gastric cancer?, Eur J Cancer, 34, 10, pp. 1480-1489, (1998)
[3]  
Volpe C.M., Driscoll D.L., Miloro S.M., Douglass Jr. H.O., Survival benefit of extended D2 resection for proximal gastric cancer, J Surg Oncol, 64, 3, pp. 231-236, (1997)
[4]  
Cuschieri A., Weeden S., Fielding J., Et al., Patient survival after D1 and D2 resections for gastric cancer: Long-term results of the MRC randomized surgical trial. Surgical Co-operative Group, Br J Cancer, 79, 9-10, pp. 1522-1530, (1999)
[5]  
Bonenkamp J.J., Hermans J., Sasako M., van de Velde C.J., Extended lymph-node dissection for gastric cancer. Dutch Gastric Cancer Group, N Engl J Med, 340, 12, pp. 908-914, (1999)
[6]  
Noguchi Y., Yamamoto Y., Morinaga S., Et al., Does pancreaticosplenectomy contribute to better survival?, Hepato Gastroenterology, 49, 47, pp. 1436-1440, (2002)
[7]  
Viste A., Haugstvedt T., Eide G.E., Soreide O., Postoperative complications and mortality after surgery for gastric cancer, Ann Surg, 207, 1, pp. 7-13, (1988)
[8]  
Gouzi J.L., Huguier M., Fagniez P.L., Et al., Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study, Ann Surg, 209, 2, pp. 162-166, (1989)
[9]  
Siewert J.R., Bottcher K., Roder J.D., Busch R., Hermanek P., Meyer H.J., Prognostic relevance of ststematic lymph node dissection in gastric carcinoma. German Gastric Carcinoma Study Group, Br J Surg, 80, 8, pp. 1015-1018, (1995)
[10]  
Bozzetti F., Marubini E., Bonfanti G., Et al., Total versus subtotal gastrectomy: Surgical morbidity and mortality rates in a multicenter Italian randomized trial. The Italian gastrointestinal Tumor Study Group, Ann Surg, 226, 5, pp. 613-620, (1997)