Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cancer

ABSTRACT

Introduction. The purpose of this study is to analyzepostoperative morbidity and mortality of patientsoperated on for gastric cancer in a single institutionduring the last twenty years, and to definerisk factors for complications.Material and methods. A retrospective study wascarried out on 434 patients who underwent gastrectomyfor gastric cancer between January 1983 andDecember 2002. Analysis of main medical and surgicalcomplications and analysis of morbidity riskfactors.Results. Overall morbidity and mortality rates were38.4% and 2.7% respectively. The most frequentcomplications were pneumonia (13%) and intra-abdominalabcesses (12%). The main cause of deathwas anastomotic dehiscence with abdominal sepsis.The last ten years mortality rate dropped from 4.7%to 0.8%. Risk factors for complications were gender(male, p = 0.01) and resection of spleen (p = 0.02) orpancreas (p = 0.002). A significantly lesser rate ofcomplications was found in patients who had underwentgastrectomy during the previous five years(p = 0.001) or with tumors located in the lower thirdof the stomach (p = 0,01).Conclusion. Morbidity of gastrectomy for gastriccancer in our institution is still high but mortalityhas decreased significantly over the last ten yearsdue to the specialization of the hospital and the surgicalteam. The main risk factor for complicationswas pancreatosplenectomy in the multivariate analysis:

RESUMEN

No disponible