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

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Abstract

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.

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References

  1. So JB, Yam A, Cheah WK, Kum CK, Goh PM. Risk factors related to operative mortality and morbidity in patients undergoing emergency gastrectomy. Br J Surg. 2000;87(12):1702–7.

    Article  PubMed  CAS  Google Scholar 

  2. Maruyama K, Sasako M, Kinoshita T, et al. Should systematic lymph node dissection be recommended for gastric cancer? Eur J Cancer. 1998;34(10):1480–9.

    Article  PubMed  CAS  Google Scholar 

  3. Volpe CM, Driscoll DL, Miloro SM, Douglass HO, Jr. Survival benefit of extended D2 resection for proximal gastric cancer. J Surg Oncol. 1997;64(3):231–6.

    Article  PubMed  CAS  Google Scholar 

  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. 1999;79(9–10):1522–30.

    Article  PubMed  CAS  Google Scholar 

  5. Bonenkamp JJ, Hermans J, Sasako M, van de Velde CJ. Extended lymph-node dissection for gastric cancer. Dutch Gastric Cancer Group. N Engl J Med. 1999; 340(12):908–14.

    Article  PubMed  CAS  Google Scholar 

  6. Noguchi Y, Yamamoto Y, Morinaga S, et al Does pancreaticosplenectomy contribute to better survival? Hepato gastroenterology. 2002;49(47):1436–40.

    PubMed  Google Scholar 

  7. Viste A, Haugstvedt T, Eide GE, Soreide O. Postoperative complications and mortality after surgery for gastric cancer. Ann Surg. 1988;207(1):7–13

    Article  PubMed  CAS  Google Scholar 

  8. Gouzi JL, Huguier M, Fagniez PL, et al. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study. Ann Surg. 1989;209(2):162–6.

    Article  PubMed  CAS  Google Scholar 

  9. Siewert JR, Bottcher K, Roder JD, Busch R, Hermanek P, Meyer HJ. Prognostic relevance of ststematic lymph node dissection in gastric carcinoma. German Gastric Carcinoma Study Group. Br J Surg. 1995;80(8):1015–8.

    Article  Google Scholar 

  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. 1997;226(5):613–20.

    CAS  Google Scholar 

  11. Smith JW, Shiu MH, Kelsey L, Brennan MF. Morbidity of radical lymphadenectomy in the curative resection of gastric carcinoma. Arch Surg. 1991;126(12):1469–75.

    PubMed  CAS  Google Scholar 

  12. Onate-Ocana LF, Aiello-Crocifoglio V, Mondragón-Sánchez R, Ruiz-Molina JM. Survival benefit of D2 lympadenectomy in patients with gastric adenocarcinoma. Ann Surg Oncol. 2000;7(5):210–7.

    Article  PubMed  CAS  Google Scholar 

  13. Roder JD, Bottcher K, Siewert JR, Busch R, Hermanek P, Meyer HJ. Prognostic factors in gastric carcinoma. Results of the German Gastric Carcinoma Study 1992. Cancer. 1995;72(7):2089–97.

    Article  Google Scholar 

  14. Ikeguchi M, Oka S, Gomyo Y, Tsujitani S, Maeta M, Kaibara N. Postoperative morbidity and mortality after gastrectomy for gastric carcinoma. Hepatogastroenterology. 2001;48(41):1517–20.

    PubMed  CAS  Google Scholar 

  15. Sasako M. Risk factors for surgical treatment in the Dutch Gastric Cancer Trial. Br J Surg. 1997;84(11):1567–71.

    Article  PubMed  CAS  Google Scholar 

  16. Yasuda K, Shiraishi N, Adachi Y, Inomata M, Sato K, Kitano S. Risk factors for complications following resection of large gastric cancer. Br J Surg. 2001;88(6):873–7.

    Article  PubMed  CAS  Google Scholar 

  17. Onate-Ocana LF, Cortés-Cárdenas SA, Aiello-Crocifoglio V, Mondragón-Sánchez R, Ruiz-Molina JM. Preoperative multivariate prediction of morbidity after gastrectomy for adenocarcinoma. Ann Surg Oncol. 2000;7(4):281–8.

    Article  PubMed  CAS  Google Scholar 

  18. Wu CW, Hsieh MC, Lo SS, et al. Morbidity and mortality after radical gastrectomy for patients with carcinoma of the stomach. J Am Coll Surg. 1995;181(1):26–32.

    PubMed  CAS  Google Scholar 

  19. Nanthakumaran S, Fernandes E, Thompson AM, Rapson T, Gilbert FJ, Park KG. Morbidity and mortality rates following gastric cancer surgery and contiguous organ removal, a population based study. Eur J Surg Oncol. 2005;51(10):1141–4.

    Article  Google Scholar 

  20. Otsuji E, Sawai K, Yamaguchi T, et al. Results of combined complete removal of directly invaded organs with the stomach in patients with advanced gastric cancer. Hepatogastroenterology. 2002;49(48):1731–3.

    PubMed  Google Scholar 

  21. Viste A, Svanes K, Janssen CW Jr, Maartmann-Moe H, Soreide O. Prognostic importance of radical lymphadenectomy in curative resections for gastric cancer. Eur J Surg. 1994;160(9):497–502.

    PubMed  CAS  Google Scholar 

  22. Otsuji E, Toma A, Kobayashi S, Cho H, et al. Long-term benefit of extended lymphadenectomy with gastrectomy in distally located early gastric carcinoma. Am J Surg. 2000;180(2):127–32.

    Article  PubMed  CAS  Google Scholar 

  23. Adachi Y, Mimori K, Mori M, Maehara Y, Sugimachi K. Morbidity after D2 and D3 gastrectomy for node-positive gastric carcinoma. J Am Coll Surg. 1997;184(3):240–4.

    PubMed  CAS  Google Scholar 

  24. Robertson CS, Chung SC, Woods SD, et al. A prospective randomized trial comparing R1 subtotal gastrectomy with R3 total gastrectomy for antral cancer. Ann Surg. 1994;220(2):176–82.

    Article  PubMed  CAS  Google Scholar 

  25. Sendler A, Etter M, Bottcher K, Siewert JR. Extent of resection in surgery of stomach carcinoma. Chirurg. 2002;73(4):316–24.

    Article  PubMed  CAS  Google Scholar 

  26. Sierra A, Reguera FM, Hernández-Lizoain JL, Pardo F, Martinez-Gonzalez MA, Álvarez-Cienfuegos J. Role of the extended lymphadenectomy in gastric cancer surgery: experience in a single institution. Ann Surg Oncol. 2003;10(3):219–26.

    Article  PubMed  Google Scholar 

  27. Lewis WG, Edwards P, Barry JD, et al. D2 or not D2? The gastrectomy question. Gastric Cancer. 2002;5(1):29–34.

    Article  PubMed  Google Scholar 

  28. Meyer HJ. The influence of case load and the extent of resection on the quality of treatment outcome in gastric cancer. Eur J Surg Oncol. 2005;51(6):595–604.

    Article  Google Scholar 

  29. Díaz de Liano A, Ciga MA, Oteiza F, Aizcorbe M, Cobo F, Trujillo R. Factors involved in morbidity and mortality of total gastrectomy for gastric cancer. Rev Oncol. 2002;4(5):265–70.

    Google Scholar 

  30. Shchepotin IB, Evans SR, Chorny VA, Shabahang M, Buras RR, Nauta RJ. Postoperative complications requiring relaparotomies after 700 gastretomies performed for gastric cancer. Am J Surg. 1996;171(2):270–3.

    Article  PubMed  CAS  Google Scholar 

  31. Grossmann EM, Longo WE, Virgo KS, et al. Morbidity and mortality of gastrectomy for cancer in Department of Veterans Affairs Medical Centers. Surgery. 2002; 131(5):484–90.

    Article  PubMed  Google Scholar 

  32. Davies J, Johnston D, Sue-Ling H, et al. Total or subtotal gastrectomy for gastric carcinoma? A study of quality of life. World J Surg. 1998;22(10:1048–55.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. General Surgery Department, Clinica Universitaria of Navarra, Pamplona, C/Pío XII, 36. 31008 Pamplona, Navarra, Spain

    A. Gil-Rendo,  Hernández-Lizoain, F. Martínez-Regueira, A. Sierra Martínez, F. Rotellar Sastre, M. Cervera Delgado, V. Valentí Azcarate, C. Pastor Idoate & J. Álvarez-Cienfuegos

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  1. A. Gil-Rendo
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  2. Hernández-Lizoain
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  3. F. Martínez-Regueira
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  7. V. Valentí Azcarate
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  9. J. Álvarez-Cienfuegos
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Correspondence to A. Gil-Rendo.

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Gil-Rendo, A., Hernández-Lizoain, Martínez-Regueira, F. et al. Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cancer. Clin Transl Oncol 8, 354–361 (2006). https://doi.org/10.1007/s12094-006-0182-x

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  • DOI: https://doi.org/10.1007/s12094-006-0182-x

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