[Effect of systematic lymphadenectomy on postoperative mortality and morbidity in patients with gastric cancer].
BACKGROUND
Surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, whether postoperative morbidity and mortality rates after gastrectomy for gastric cancer have been reduced or not in recent years is still unclear. In this study we would like to point out the role of systematic lymphadenectomy in postoperative mortality and morbidity.


METHODS
In this investigation we analyzed two groups of patients. The first group of 126 patients with gastric carcinoma underwent peritumor lymphadenectomy DI. The second group of 114 patients with gastric carcinoma underwent more radical types of lymphadenectomy (D2, D2+, D3). In this study we analyzed differences between these two groups of patients in regard to. 1) early postoperative mortality, 2) early postoperative complications and 3) long-term postoperative complications.


RESULTS
Early postoperative mortality rate was 4.76% in D1 group and 5.26% in group with systematic lymphadenectomy (SL). 14.3% of patients in D1 group and 15.7% of patients in SL group had postoperative complications. The most frequent complications in D1 group were non-surgical complications of the respiratory system. In SL group the most common postoperative complications were anastomotic leakage (5/18, 27.77%) and wound infection (6/18, 33.3%). The most common long-term complications in both groups were: ventral postoperative hernia, anemia, small bowel obstruction and gallbladder calculosis.


CONCLUSIONS
Early postoperative death occurred in patients with stage IV gastric cancer. The rates of anastomotic leakage, as main cause of early postoperative mortality and morbitity in patients with systematic lymphadenectomy, were reduced in the last few years with stapling surgery.


CONCLUSIONS
There were no significant differences in the postoperative mortality and morbidity rates between the two analyzed groups in our investigation.
Stevanović
Dejan
D
Klinika za hirurgiju, KBC Dr Dragisa Misović, Beograd. deves@yubc.net
Radovanović
Dragan
D
Pavlović
Ivan
I
Mitrović
Nebojsa
N
D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D013274:Stomach Neoplasms / Q000601:surgery*