Risk factors for operative mortality and morbidity in gastric cancer undergoing D2-gastrectomy.
OBJECTIVE
We have assessed the risk factors for mortality and morbidity subsequent to D2-gastrectomy in gastric cancer cases.


METHODS
The records (age, gender, comorbidity, ASA score, POSSUM score, type of gastrectomy, additional organ resection and pathologic TNM stage) were reviewed in 49 cases of D2 gastrectomies (between 2003 and 2008) retrospectively.


RESULTS
Mean age was 60.4 (range: 35-82). The factors of comorbidity (n=38) in 27 patients. The average quantity of lymph nodes was 21.2 (range: 16-31) in D2 dissections. The rate of mortality was 8.2% (4/49). All the patients who died had major comorbid diseases and all were submitted to total gastrectomy. Twenty-one morbidities were detected in 13 patients [morbidity rate was 26.5% (13/49)]. We have observed a nearly statistically significant (p=0.074) disadvantage of total gastrectomy versus subtotal gastrectomy [those who died had undergone total gastrectomy, and the morbidity rates were 36.4% vs 14.8%] in concordance with literature.


CONCLUSIONS
In these studies, we have observed that our mortality (8.2%) and morbidity (26.5%) rates are in concordance with the data from medical literature, and POSSUM scores are the only parameter in positive statistical correlation with mortality. Preoperative and postoperative resuscitation are of great importance if the patients have POSSUM score >20.
Koksoy
Ferda N
FN
Department of Surgery, Ministry of Health, Taksim Training and Research Hospital, Istanbul, Turkey. ferdakoksoy@yahoo.com
Gonullu
Dogan
D
Catal
Oguz
O
Kuroglu
Erol
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000601:surgery*