Increased morbidity rates in patients with heart disease or chronic liver disease following radical gastric surgery.
BACKGROUND
The aim of this study was to investigate possible associations between (i) comorbid disease and (ii) perioperative risk factors and morbidity following radical surgery for gastric cancer.


METHODS
Consecutive patients (759) undergoing radical gastrectomy and D2 level lymph node dissection for gastric cancer were included. Clinical data concerning patient characteristics, operative methods, and complications were collected prospectively.


RESULTS
The morbidity rate for radical gastrectomy was 14.2% (108/759). The most significant comorbid risk factors for postoperative morbidity were heart disease [anticoagulant medication: OR = 1.5 (95% CI = 0.35-6.6, P = 0.53); history without medication: OR = 4.0 (95% CI = 1.1-14.6, P = 0.03); history with current medication: OR = 6.7 (95% CI = 1.5-29.9, P = 0.01)] and chronic liver disease [chronic hepatitis: OR = 2.4 (95% CI = 0.9-6.5, P = 0.07); liver cirrhosis class A: OR = 8.4 (95% CI = 2.8-25.3, P = 0.00); liver cirrhosis class B: OR = 9.38 (95% CI = 0.7-115.5, P = 0.08)]. The most significant perioperative risk factors for postoperative morbidity were high TNM stage and combined organ resection (P < 0.05), and there was no association between increased postoperative morbidity and well controlled hypertension, anticoagulant therapy, diabetes mellitus, pulmonary disease, tuberculosis, or thyroid disease (P > 0.05).


CONCLUSIONS
Patients with heart disease or chronic liver disease are at a higher risk of morbidity following radical surgery for gastric cancer.
Jeong
Sang-Ho
SH
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Ahn
Hye Sung
HS
Yoo
Moon-Won
MW
Cho
Jae-Jin
JJ
Lee
Hyuk-Joon
HJ
Kim
Hyung-Ho
HH
Lee
Kuhn-Uk
KU
Yang
Han-Kwang
HK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*