title: Post-operative complications of gastric cancer surgery: female gender at high risk.
abstract: We applied physiological and operative severity score for the enumeration of morbidity and mortality (POSSUM) to evaluate overall surgical outcome and investigated the role of gender for early post-operative complications in gastric cancer surgery. The data from a total of 357 patients of gastric cancer were analysed by univariate and multivariate analysis. Post-operative complications were recorded according to definition of POSSUM. Post-operative complications of male and female patients were compared separately. The observed to estimated morbidity ratio (O:E) was 1.01. Among the pre-operative variables, patient gender was one of the independent risk factors for a higher rate of post-operative complications (risk ratio 1.777, P = 0.024). Post-operative complication was significantly higher in female patients. Similarly, post-operative length of stay was significantly longer and more severe complications were observed in female patients (P = 0.03). In conclusion, POSSUM system is a valid algorithm for risk-adjusted surgical audit. We conclude that a patient's gender influences the early post-operative complications after gastric cancer surgery. A detailed understanding on disparity of early post-operative complications between men and women may provide valuable information to improve surgical outcome of gastric cancer. However, results of this study need further confirmation by a prospective study involving a larger cohort.
authors.affiliation: Department of General Surgery, Rui Jin Hospital, Shanghai Jiao Tong University, School of Medicine. Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: B K
authors.initials: BK
authors.lastname: Sah
authors.forename: Z G
authors.initials: ZG
authors.lastname: Zhu
authors.forename: X Y
authors.initials: XY
authors.lastname: Wang
authors.forename: Q M
authors.initials: QM
authors.lastname: Yang
authors.forename: M M
authors.initials: MM
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Xiang
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: M
authors.initials: M
authors.lastname: Yan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000401:mortality* / Q000601:surgery; D055815:Young Adult