title: Postoperative Morbidity and Mortality Following D2 Gastrectomy-an Audit of 456 Cases.
abstract: BACKGROUND
  D2 gastrectomy is routinely performed in Japanese centres for carcinoma stomach with low morbidity and mortality. There were concerns in Western centres with regard to D2 gastrectomy in view of high morbidity and mortality rates. This study was aimed to study the postoperative morbidity and mortality following D2 gastrectomy for carcinoma stomach in a high volume centre in India.
  
  
  METHODS
  It was a retrospective analysis of all the patients who underwent D2 gastrectomy from 1991 to 2010.
  
  
  RESULTS
  D2 gastrectomy was performed in 456 patients during this period. Respiratory events were the most common cause of morbidity in the study group (2.4 %). Male gender (p = 0.007), presence of gastric outlet obstruction (p = 0.01) and pathological T4 (p = 0.05) independently predicted increased post operative morbidity in multivariate analysis. The morbidity and mortality rates declined with increase in hospital volume and experience of the surgeon.
  
  
  CONCLUSIONS
  D2 gastrectomy for carcinoma stomach can be performed safely in specialized centres with low morbidity and mortality rates.
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Dr.S.Krishnamurthy Campus, No. 18, Sardar Patel road, Guindy, Chennai, 600036 India.
authors.forename: Bhanu Jayanand
authors.initials: BJ
authors.lastname: Sunil
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Dr.S.Krishnamurthy Campus, No. 18, Sardar Patel road, Guindy, Chennai, 600036 India.
authors.forename: Ramakrishnan Ayloor
authors.initials: RA
authors.lastname: Seshadri
authors.affiliation: Madras Cancer Care Foundation, Chennai, India.
authors.forename: Vikash
authors.initials: V
authors.lastname: Mahajan
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Dr.S.Krishnamurthy Campus, No. 18, Sardar Patel road, Guindy, Chennai, 600036 India.
authors.forename: Hemanth Raj
authors.initials: HR
authors.lastname: Ellusami
keywords: Carcinoma stomach; D2 gastrectomy; Morbidity; Mortality