Postoperative morbidity and mortality after gastrectomy for gastric carcinoma

Background/Aims: Surgical technique and postoperative care for gastric canc er have significantly improved in recent years. However, whether postoperat ive morbidity or mortality rates after gastrectomy for gastric cancer were reduced or not in recent years was unclear. In this study, we analyzed the chronological changes of postoperative morbidity and mortality rates, and w e analyzed risk factors for postoperative morbidity and mortality in patien ts undergoing gastrectomy for carcinomas of the stomach. Methodology: A total of 887 patients with gastric cancer were gastrectomize d in our hospital between January 1985 and December 1996. The patients were divided into three groups on the basis of chronology. The first group incl uded patients treated over the period 1985 to 1988 (n = 324); the second gr oup, 1989 to 1992 (n = 300); and the third group, 1993 to 1996 (n = 263). P ostoperative morbidity rates and mortality rates were compared among the th ree groups. Also, significant risk factors affecting postoperative morbidit y and in-hospital mortality were analyzed by the multiple logistic regressi on analysis. Results: Postoperative complications were detected in 95 patients (10.7%) a nd in-hospital mortality rate was 2.4% (21/887). Postoperative morbidity ra tes were 10.5%, 11%, and 10.6% in the first, second, and third groups, resp ectively and postoperative mortality rates were 2.5%, 2%, and 2.7%, respect ively. These postoperative morbidity and mortality rates were not different between the groups (P = 0.979 and P = 0.866). The most common postoperativ e complication was anastomotic leakage (56/95, 58.9%). Significant risk fac tors affecting in-hospital mortality were Stage IV (P = 0.006) and noncurat ive gastric resection (P = 0.004). However, the extent of lymph node dissec tion, combined resection, or the existence of preoperative complications we re not significant risk factors of in-hospital mortality by multiple logist ic regression analysis. Conclusions: These results indicate that patients with far-advanced gastric cancer might have a high risk of postoperative mortality. In noncurative o perations for patients with advanced gastric cancer, unnecessary lymph node dissection or combined resection should be avoided.