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Digestive cancer surgery in low-mid income countries: analysis of postoperative mortality and complications in a single-center study

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Abstract

Purpose

This study aimed to analyze postoperative and 90-day morbidity and mortality and their risk factors in all digestive cancer curative intent resections of a single digestive surgical department in a low-mid income country.

Methods

All consecutive patients who underwent a surgical resection for digestive cancer with a curative intent between January 1, 2021, and December 31, 2021, were included. This is a retrospective analysis of a prospective cancer surgery database managed during the period. Patterns and factors associated with increased morbidity and mortality were analyzed and presented in tabular and descriptive forms.

Results

Seventy-six patients were included, 38 (50%) were men with a mean age of 59 years (±13.5). Forty patients (52.63%) had tumors locally advanced, staged CT3–CT4 on preoperative imagery. Thirty-three of our population (43.42%) had laparoscopic surgery (conversion rate at 12.12%). In immediate preoperative, the morbidity rate was 36.84%; among each, 7 patients (9.21%) had serious complications (>2 Clavien-Dindo grade), and mortality rate was 5.26%. At 90 days after surgery, morbidity remained the same, and mortality increased to 7.9%. Risk factors for increased morbidity and mortality were female gender, obesity, high levels of carcinoembryonic antigen, hypoalbuminemia, laparotomy approach, hand sewn anastomosis, prolonged operating time, and wide drainage (p < 0.05).

Conclusions

This study provides figures on mortality and morbidity related to digestive cancer curative surgery in a low-mid income country digestive department and discusses risk factors increasing postoperative complications and death.

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Data availability

The data that support the findings of this article are available from the corresponding author upon reasonable request.

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Acknowledgements

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Funding

The authors have no source of funding or financial support except themselves.

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Authors and Affiliations

  1. Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco

    Hamza Sekkat, Hassan Agouzoul, Zineb Loudyi, Jaouad Naddouri, Jihane El Hamzaoui, Youness Bakali, Mouna Mhamdi Alaoui, Mohammed Raiss, Abdelmalek Hrora & Farid Sabbah

  2. Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

    Hamza Sekkat, Hassan Agouzoul, Zineb Loudyi, Jaouad Naddouri, Jihane El Hamzaoui, Youness Bakali, Mouna Mhamdi Alaoui, Mohammed Raiss, Abdelmalek Hrora & Farid Sabbah

  3. Statistics Department, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah, Fez, Morocco

    Samira El Fakir & Mohammed Omari

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  1. Hamza Sekkat
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  2. Hassan Agouzoul
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Contributions

All authors contributed to the study conception and design. F. S. designed the study; S. E. F. and M. O. performed the statistical analysis. H. S., Z. L., and H. A. collected the data; H. S. and N. J. wrote the first draft of the manuscript. J. E. H. participated in the study design and critically reviewed the manuscript. B. Y., R. M., M. M. A., A. H. and F. S. critically reviewed the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Hamza Sekkat.

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Ethical approval and consent

The study was approved by the Ethics committee of the Mohammed V University in Rabat

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All patients consented to use their data for scientific study and publication purposes.

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The authors declare no competing interests.

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Sekkat, H., Agouzoul, H., Loudyi, Z. et al. Digestive cancer surgery in low-mid income countries: analysis of postoperative mortality and complications in a single-center study. Langenbecks Arch Surg 408, 414 (2023). https://doi.org/10.1007/s00423-023-03156-0

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