Risk factors for operative mortality and morbidity in gastric cancer undergoing D2-gastrectomy

Abstract

Aim: We have assessed the risk factors for mortality and morbidity subsequent to D2-gastrectomy in gastric cancer cases.

Patients and method: 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.

Conclusion: 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.