Fatal and non-fatal complications after surgical resection for gastric cancer.
OBJECTIVE
We divided overall complications after surgical resection for gastric cancer into fatal and non-fatal, and examined them in view of risk factors. Next we examined the meaning of dividing complications into two groups.


METHODS
Records of 331 patients who underwent gastrectomies for cancer between 1992 and 2003 were used. Any postoperative overall complications were divided into fatal and non-fatal according to the association with mortality.


RESULTS
Leakage and respiratory complication were defined as fatal complications. Tumor size (cm) (OR=1.14, 95% CI 1.05-1.25, p=0.003) and patient age (OR=1.06, 95% CI 1.06-1.10, p=0.007) were shown to be risk factors for fatal complications. Total gastrectomy (vs. distal gastrectomy) was a risk factor for non-fatal complications (OR= 1.63, 95% CI 0.99-2.7, p=0.05). Extended lymphadenectomy was a further possible risk factor for non-fatal complications (OR=1.71, 95% CI 0.98-3.0, p=0.06). On the other hand, intra-operative blood loss (mL) was only a risk factor for overall complications (OR=1.001, 95% CI 1.0-1.001, p=0.009).


CONCLUSIONS
Independent risk factors for fatal complications and those for non-fatal complications did not include that for overall complications. To divide overall complications into fatal or non-fatal was useful for finding the real reason for complications. We could not prepare preventive measures for complications until analyzing the divided groups.
Tonouchi
Hitoshi
H
Department of Innovative Surgery, Mie University School of Medicine, Japan.
Ohmori
Yukinari
Y
Tanaka
Kouji
K
Mohri
Yasuhiko
Y
Kobayashi
Minako
M
Kusunoki
Masato
M
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000601:surgery*