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Factors involved in morbidity and mortality of total gastrectomy for gastric cancer

Factores implicados en la morbimortalidad de la gastrectomía total por cáncer gástrico

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Abstract

Total gastrectomy is a surgical procedure with a high morbidity and mortality. This retrospective study is intended to assess the impact of pre, peri and postoperative variables upon the development of complications and mortality after total gastrectomy in 203 patients with gastric cancer. The variables studied included age, sex, associated diseases, resection of the spleen and tail of the pancreas, lymphadenectomy, type of anastomosis, duration of surgery, need for blood transfusion, development of complications, and mortality.

Resection of the spleen and the tail of the pancreas and the need for transfusion were found to be independent prognostic factors for the development of postoperative complications. Mortality significantly increased with a history of bronchial disease, esophagojejunal dehiscence, intraabdominal abscesses and the need for repeat surgery.

Morbidity and mortality associated to total gastrectomy for stomach cancer therefore appear to be more dependent upon peri- and postoperative variables than on patient age or associated diseases.

Resumen

La gastrectomía total es una intervención con una morbimortalidad elevada. En este trabajo pretendemos valorar el impacto de variables pre, peri y postoperatorias en el desarrollo de complicaciones y mortalidad tras gastrectomía total por cáncer gástrico. Se realizó un estudio retrospectivo de 203 pacientes sometidos a gastrectomía total por cáncer gástrico. Las variables estudiadas fueron: edad, sexo, patología asociada, si se resecaron bazo y cola del páncreas, linfadenectomía realizada, tipo de anastomosis, tiempo quirúrgico, necesidad de transfusión, desarrollo de complicaciones y mortalidad. La resección del bazo y cola del páncreas y la necesidad de transfusión fueron factores pronósticos independientes para el desarrollo de complicaciones postoperatorias. La mortalidad aumentó significativamente con el antecedente de broncopatía, la dehiscencía esófago-yeyunal, el absceso intraabdominal y la necesidad de reintervención.

Parece, pues, que la morbimortalidad asociada a gastrectomía total por cáncer depende más de variables peri y postoperatorias que de la edad o patología asociada del enfermo.

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References

  1. 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;181:26–32.

    CAS  PubMed  Google Scholar 

  2. Cuschieri A, Fayers P, Fielding J, et al. Postoperative morbidity and mortality after D1 and D2 resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. Lancet 1996;347:995–9.

    Article  CAS  PubMed  Google Scholar 

  3. Bonenkamp JJ, Songun I, Hermans J, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995;345:745–8.

    Article  CAS  PubMed  Google Scholar 

  4. Yasuda K, Shiraishi N, Adachi Y, et al. Risk factors for complications following resection of large gastric cancer. Br J Surg 2001;88:873–7.

    Article  CAS  PubMed  Google Scholar 

  5. Robertson CS, Chung SGS, Woods SDS, et al. A prospective randomized trial comparing R1 subtotal gastrectomy with R3 total gastrectomy for antral cancer. Ann Surg 1994;220:176–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Otsuji E, Yamaguchi T, Sawai K, et al. Total gastrectomy with simultaneus pancreaticosplenectomy or splenectomy in patients with advanced gastric carcinoma. Br J Cancer 1999;79:1789–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Planells Roig MV, López Martínez C, Ballester C, et al. Factores predictivos de mortalidad en pacientes sometidos a gastrectomía total por adenocarcinoma gástrico. Cir Esp 1998;64:129–35.

    Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kwon SJ, members of the Korean Gastric Cancer Study Group. Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group. World J Surg 1997;21:837–44.

    Article  CAS  PubMed  Google Scholar 

  10. Adachi Y, Mimori K, Mori M, et al. Morbidity after D2 and D3 gastrectomy for node-positive gastric carcinoma. J Am Coll Surg 1997;184:240–4.

    CAS  PubMed  Google Scholar 

  11. Bozzetti F, Marubini E, Bonfanti G, et al. Total versus subtotal gastrectomy. Surgical morbidity and mortality in a multicenter Italian randomized trial. Ann Surg 1997; 226:613–620.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Siewert JR, Böttcher K, Stein HJ, et al and the German Gastric Cancer Study Group. Relevant prognostic factors in gastric cancer. Ten-year results of the German Gastric Cancer Study. Ann Surg 1998;228:449–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sasako M for the Dutch Gastric Cancer Study Group. Risk factors for surgical treatment in the Dutch gastric cancer trial. Br J Surg 1997;84:1567–71.

    Article  CAS  PubMed  Google Scholar 

  14. Brady MS, Rogatko A, Dent LL, et al. Effect of splenectomy on mortality and survival following curative gastrectomy for carcinoma. Arch Surg 1991;126:359–64.

    Article  CAS  PubMed  Google Scholar 

  15. Kasakura Y, Fujii M, Mochizuki F, et al. Is there a benefit of pancreaticosplenectomy with gastrectomy for advanced gastric cancer? Am J Surg 2000;179:237–42.

    Article  CAS  PubMed  Google Scholar 

  16. Kitamura K, Nishida S, Ichikawa D, et al. No survival benefit from combined pancreaticosplenectomy and total gastrectomy for gastric cancer. Br J Surg 1999;86:119–22.

    Article  CAS  PubMed  Google Scholar 

  17. Siewert JR. Letters to the Editor. Author's Reply. Ann Surg 1999;230:451.

    Article  Google Scholar 

  18. Adachi Y, Kamamura T, Mori M, et al. Role of lymph node dissection and splenectomy in node-positive gastric carcinoma. Surgery 1994;116:837–41.

    CAS  PubMed  Google Scholar 

  19. Pacelli F, Doglieto GB, Bellantone R, et al. Extensive versus limited lymph node dissection for gastic cancer: a comparative study of 320 patients. Br J Surg 1993;80: 1153–6.

    Article  CAS  PubMed  Google Scholar 

  20. Smith JW, Shiu MH, Kelsey L, et al. Morbidity of radical lymphadenectomy in the curative resection of gastric carcinoma. Arch Surg 1991;126:1469–73.

    Article  CAS  PubMed  Google Scholar 

  21. Roder JD, Böttcher K, Siewert JR, et al. Prognostic factors in gastric carcinoma. Results of the German Gastric Carcinoma Study 1992. Cancer 1993;72:2089–97.

    Article  CAS  PubMed  Google Scholar 

  22. Díaz de Liaño A, Aizcorbe M, Trujillo R, et al. Dehiscencia de la anastomosis esofagoyeyunal tras gastrectomía total por carcinoma gástrico. Cir Esp 1999;65:127–9.

    Google Scholar 

  23. Ruiz de Arana JC, Ortega Deballon P, Alonso García MT, et al. Morbimortalidad atribuible a la fístula esofagoyeyunal tras gastrectomía total por cáncer gástrico. Cir Esp 2001;70:3–5.

    Article  Google Scholar 

  24. Viste A, Geir E, Soreide O. Stomach cancer: a prospective study of anastomotic failure following total gastrectomy. Acta Chir Scand 1987;153:303–6.

    CAS  PubMed  Google Scholar 

  25. Schardey HM, Joosten U, Finke U, et al. The prevention of anastomotic leakage after total gastrectomy with local decontamination. A prospective, randomized, doubleblind, placebo-controlled multicenter trial. Ann Surg 1997;225:172–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of General and Gastrointestinal Surgery, Virgen del Camino Hospital, Pintor Maeztu, 2, 8 C, 31008, Pamplona

    Álvaro Díaz de Liaño Argüelles, Miguel Ángel Ciga Lozano, Fabiola Oteiza Martínez, Miguel Aizcorbe Garralda, Francisco Cobo Huici & Ramón Trujillo Ascanio

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  1. Álvaro Díaz de Liaño Argüelles
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  2. Miguel Ángel Ciga Lozano
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  3. Fabiola Oteiza Martínez
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  4. Miguel Aizcorbe Garralda
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  5. Francisco Cobo Huici
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  6. Ramón Trujillo Ascanio
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Díaz de Liaño Argüelles, Á., Ciga Lozano, M.Á., Martínez, F.O. et al. Factors involved in morbidity and mortality of total gastrectomy for gastric cancer. Rev Oncol 4, 265–270 (2002). https://doi.org/10.1007/BF02732512

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  • DOI: https://doi.org/10.1007/BF02732512

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