Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cancer.
BACKGROUND
The purpose of this study is to analyze postoperative morbidity and mortality of patients operated on for gastric cancer in a single institution during the last twenty years, and to define risk factors for complications.


METHODS
A retrospective study was carried out on 434 patients who underwent gastrectomy for gastric cancer between January 1983 and December 2002. Analysis of main medical and surgical complications and analysis of morbidity risk factors.


RESULTS
Overall morbidity and mortality rates were 38.4% and 2.7% respectively. The most frequent complications were pneumonia (13%) and intra-abdominal abcesses (12%). The main cause of death was anastomotic dehiscence with abdominal sepsis. The last ten years mortality rate dropped from 4.7% to 0.8%. Risk factors for complications were gender (male, p = 0.01) and resection of spleen (p = 0.02) or pancreas (p = 0.002). A significantly lesser rate of complications was found in patients who had underwent gastrectomy during the previous five years (p = 0.001) or with tumors located in the lower third of the stomach (p = 0,01).


CONCLUSIONS
Morbidity of gastrectomy for gastric cancer in our institution is still high but mortality has decreased significantly over the last ten years due to the specialization of the hospital and the surgical team. The main risk factor for complications was pancreatosplenectomy in the multivariate analysis.
Gil-Rendo
A
A
General Surgery Department, Clinica Universitaria of Navarra, Pamplona, Navarra, Spain. agilrendo@telefonica.net
Hernández-Lizoain
J L
JL
Martínez-Regueira
F
F
Sierra Martínez
A
A
Rotellar Sastre
F
F
Cervera Delgado
M
M
Valentí Azcarate
V
V
Pastor Idoate
C
C
Alvarez-Cienfuegos
J
J
D018784:Abdominal Abscess / Q000453:epidemiology; D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000706:statistics & numerical data; D005260:Female; D005743:Gastrectomy / Q000706:statistics & numerical data*; D046449:Hernia, Abdominal / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010180:Pancreatectomy / Q000706:statistics & numerical data; D010185:Pancreatic Fistula / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D013156:Splenectomy / Q000706:statistics & numerical data; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013997:Time Factors