Determinants of surgical morbidity in gastric cancer treatment.
BACKGROUND
The occurrence of early surgical complications after gastrectomy as a treatment for gastric cancer has been reported to have a negative impact on longterm survival. The aim of this study was to identify treatment-related factors that can predict morbidity and mortality in patients undergoing operations for gastric cancer.


METHODS
The charts of 388 patients who underwent different operations for gastric cancer at A Gemelli General Hospital, Catholic University of Rome, Italy, between January 1992 and April 2007, were reviewed. Patients were grouped according to the type of surgical treatment performed. The study end points were postoperative morbidity, mortality, and the length of hospital stay after surgery.


RESULTS
Overall morbidity and mortality rates were 16.2% (63 patients) and 2.3% (9 patients), respectively. Overall morbidity rates were higher in patients more than 64 years of age, when a gastric tumor was resected along with the spleen, and when an extended lymphadenectomy was performed. Patients older than 64 years had longer postoperative hospital stays, and Roux-en-Y gastrojejunostomy was predictive of a shorter stay. Mortality was not influenced by any surgically related factors.


CONCLUSIONS
Age, splenectomy, and extended lymphadenectomy were independently associated with the development of complications after gastric cancer operations. After subtotal gastrectomy, Roux-en-Y gastrojejunostomy was associated with a shorter postoperative length of stay than conventional Billroth I and Billroth II reconstructions.
Persiani
Roberto
R
Department of Surgery, 1st General Surgery Unit, Catholic University of Rome, Rome, Italy.
Antonacci
Vincenzo
V
Biondi
Alberto
A
Rausei
Stefano
S
La Greca
Antonio
A
Zoccali
Marco
M
Ciccoritti
Luigi
L
D'Ugo
Domenico
D
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass; D005763:Gastroenterostomy; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*