Effect of comorbidities on postoperative complications in patients with gastric cancer after laparoscopy-assisted total gastrectomy: results from an 8-year experience at a large-scale single center
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Comorbidity is a predictor of postoperative complications in gastrectomy. However, it remains unclear which comorbidities are predictors of postoperative complications in gastric cancer patients who have undergone laparoscopy-assisted total gastrectomy (LATG). The purpose of this study was to evaluate the effect of comorbidities on the surgical outcomes of patients with gastric cancer after LATG.
We retrospectively collected data on 1657 gastric cancer patients who underwent LATG between January 2008 and December 2015. We investigated the incidences, types, and risk factors for postoperative complications after LATG. Patients were enrolled in analysis to evaluate the effects of comorbidities on postoperative complications.
The number of postoperative complications was associated with the number of comorbidities in the gastric cancer patients according to the operative period. Of the 1657 patients included in this study, 714 (43.1 %) had one or more comorbidities. Postoperative complications occurred in 283 patients (17.1 %), and 6 patients (0.4 %) died during hospitalization. With an increasing number of comorbidities, the incidence of local and systemic complications also increased. Univariate and multivariate analyses revealed that comorbidity was a predictive risk factor for local complications (OR 1.204, 1.014–1.431) and systemic complications (OR 1.237, 1.039–1.474). Diabetes mellitus, anemia, pulmonary disease, and renal dysfunction were found to be associated with postoperative complications, including abdominal bleeding, anastomotic leakage, and pneumonia.
Our study has revealed that comorbidities could be a predictive risk factor for postoperative complications after LATG. Surgeons should carefully assess patients with full perioperative attention to some specific types of comorbidities.
KeywordsGastric cancer Laparoscopy Gastrectomy Complications
The authors are thankful to Fujian Medical University Union Hospital for her management of our gastric cancer patient database.
This study was funded by the National Key Clinical Specialty Discipline Construction program of China (No. 649) and the Key Projects of Science and Technology Plan of Fujian Province (No. 2014Y0025).
Compliance with ethical standards
Drs. Jia-Bin Wang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, and Chang-Ming Huang have no conflicts of interest or financial ties to disclose.
- 6.Chen RF, Huang CM, Chen QY, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Lu J, Cao LL, Lin M (2015) Why the proximal splenic artery approach is the ideal approach for laparoscopic suprapancreatic lymph node dissection in advanced gastric cancer? A large-scale vascular-anatomical-based study. Med (Baltimore) 94:e832CrossRefGoogle Scholar
- 10.Carless PA, Henry DA, Carson JL, Hebert PP, McClelland B, Ker K (2010) Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD002042.pub2
- 23.Imai E, Horio M, Iseki K, Yamagata K, Watanabe T, Hara S, Ura N, Kiyohara Y, Hirakata H, Moriyama T, Ando Y, Nitta K, Inaguma D, Narita I, Iso H, Wakai K, Yasuda Y, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S (2007) Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol 11:156–163CrossRefPubMedGoogle Scholar