Analysis of Related Factors of Postoperative Severe Complications in Elderly Patients with Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHOU Liyu , SUN Libo , LI Yongchao , DING Dayong , SHU Zhengbo , ZHENG Zelin.

Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China;

Corresponding author：

Keywords：

Old age; Gastric cancer; Postoperative complication

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ObjectiveTo analyze the related risk factors of influencing on postoperative severe complications (PSC) in elderly patients with gastric cancer. MethodsAltogether 202 cases of elderly patients with gastric cancer who received surgical treatment between January 2003 and December 2008 in this hospital were analyzed. On the basis of the degree of complications, the patients were divided into the group with PSC and the group without PSC. The relevant clinical and laboratory data were evaluated, and compared with statistical analysis. ResultsClinically the preoperative comorbidity, total gastrectomy, more than 800 ml intraoperative blood loss, intraoperative transfusion, and combined organ resection were significantly correlated with PSC (P lt;0.05). In laboratory data, the lower preoperative serum albumin and the blood glucose level on the first day after operation were significantly correlated with PSC (P lt;0.05). ConclusionThe preoperative comorbidity, lower serum albumin, and extended radical resection are the danger factors leading to PSC.

Citation： ZHOU Liyu,SUN Libo,LI Yongchao,DING Dayong,SHU Zhengbo,ZHENG Zelin.. Analysis of Related Factors of Postoperative Severe Complications in Elderly Patients with Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(6): 639-642. doi: Copy

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7.	Tonouchi H, Ohmori Y, Tanaka K, et al. Fatal and nonfatal complications after surgical resection for gastric cancer [J]. Hepatogastroenterology, 2006, 53(67): 145149.
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13.	Kunisaki C, Shimada H, Ono H, et al. Predictive factors for pancreatic fistula after pancreaticosplenectomy for advanced gastric cancer in the upper third of the stomach [J]. J Gastrointest Surg, 2006, 10(1): 132137.
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15.	AWeitz J, Jaques DP, Brennan M, et al. ssociation of splenectomy with postoperative complications in patients with proximal gastric and gastroesophageal junction cancer [J]. Ann Surg Oncol, 2004, 11(7): 682689.
16.	崔超, 孙立波, 舒振波, 等. 进展期近端胃癌根治术联合脾脏切除术适应证的选择 [J]. 中国普外基础与临床杂志, 2010, 17(1): 2224.
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22.	Otsuji E, Fujiyama J, Takagi T, et al. Results of total gastrectomy with extended lymphadenectomy for gastric cancer in elderly patients [J]. J Surg Oncol, 2005, 91(4): 232236.
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24.	Tsujinaka T, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Influence of overweight on surgical complications for gastric cancer: results from a randomized control trial comparing D2 and extended paraaortic D3 lymphadenectomy (JCOG9501) [J]. Ann Surg Oncol, 2007, 14(2): 355361.
25.	周岩冰, 张坚, 李世宽, 等. 胃癌术后并发症多因素Logistic回归分析及风险模型的建立 [J]. 中华普通外科杂志, 2007, 22(3): 164167.

1. Finlayson EV, Birkmeyer JD. Operative mortality with elective surgery in older adults [J]. Eff Clin Pract, 2001, 4(4): 172177.
2. So JB, Yam A, Cheah WK, et al. Risk factors related to operative mortality and morbidity in patients undergoing emergency gastrectomy [J]. Br J Surg, 2000, 87(12): 17021707.
3. Whiteley MS, Prytherch DR, Higgins B, et al. An evaluation of the POSSUM surgical scoring system [J]. Br J Surg, 1996, 83(6): 812815.
4. Hariharan S, Zbar A. Risk scoring in perioperative and surgical intensive care patients: a review [J]. Curr Surg, 2006, 63(3): 226236.
5. Neary WD, Heather BP, Earnshaw JJ. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) [J]. Br J Surg, 2003, 90(2): 157165.
6. Sah BK, Zhu ZG, Chen MM, et al. Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment [J]. Langenbecks Arch Surg, 2009, 394(1): 4147.
7. Tonouchi H, Ohmori Y, Tanaka K, et al. Fatal and nonfatal complications after surgical resection for gastric cancer [J]. Hepatogastroenterology, 2006, 53(67): 145149.
8. 樊涛, 戴冬秋, 徐惠锦, 等. 老年胃癌患者并存疾病的围手术期处理 [J]. 中国普外基础与临床杂志, 2009, 16(12): 10171024.
9. Bozzetti F, Gianotti L, Braga M, et al. Postoperative complications in gastrointestinal cancer patients: the joint role of the nutritional status and the nutritional support [J]. Clin Nutr, 2007, 26(6): 698709.
10. 鲁修明, 孙立波, 李永超, 等. 70岁以上老年胃癌患者术后早期停止胃肠减压恢复肠内营养的临床观察 [J]. 中国普外基础与临床杂志, 2009,10(1): 87.
11. Sungurtekin H, Sungurtekin U, Balci C, et al. The influence of nutritional status on complications after major intraabdominal surgery [J]. J Am Coll Nutr, 2004, 23(3): 227232.
12. Yasuda K, Shiraishi N, Adachi Y, et al. Risk factors for complications following resection of large gastric cancer [J]. Br J Surg, 2001, 88(6): 873877.
13. Kunisaki C, Shimada H, Ono H, et al. Predictive factors for pancreatic fistula after pancreaticosplenectomy for advanced gastric cancer in the upper third of the stomach [J]. J Gastrointest Surg, 2006, 10(1): 132137.
14. 何裕隆. 胃癌根治术中联合胰腺、脾脏切除的问题 [J]. 外科理论与实践, 2008, 13(1): 911.
15. AWeitz J, Jaques DP, Brennan M, et al. ssociation of splenectomy with postoperative complications in patients with proximal gastric and gastroesophageal junction cancer [J]. Ann Surg Oncol, 2004, 11(7): 682689.
16. 崔超, 孙立波, 舒振波, 等. 进展期近端胃癌根治术联合脾脏切除术适应证的选择 [J]. 中国普外基础与临床杂志, 2010, 17(1): 2224.
17. Hyung WJ, Noh SH, Shin DW, et al. Adverse effects of perioperative transfusion on patients with stage Ⅲ and Ⅳ gastric cancer [J]. Ann Surg Oncol, 2002, 9(1): 512.
18. Bellantone R, SitgesSerra A, Bossola M, et al. Transfusion timing and postoperative septic complications after gastric cancer surgery: a retrospective study of 179 consecutive patients [J]. Arch Surg, 1998, 133(9): 988992.
19. Chen G, Zhang FJ, Gong M, et al. Effect of perioperative autologous versus allogeneic blood transfusion on the immune system in gastric cancer patients [J]. J Zhejiang Univ Sci B, 2007, 8(8): 560565.
20. Marrelli D, Pedrazzani C, Neri A, et al. Complications after extended (D2) and superextended (D3) lymphadenectomy for gastric cancer: analysis of potential risk factors [J]. Ann Surg Oncol, 2007, 14(1): 2533.
21. Shen JG, Cheong JH, Hyung WJ, et al. Pretreatment anemia is associated with poorer survival in patients with stage Ⅰ and Ⅱ gastric cancer [J]. J Surg Oncol, 2005, 91(2): 126130.
22. Otsuji E, Fujiyama J, Takagi T, et al. Results of total gastrectomy with extended lymphadenectomy for gastric cancer in elderly patients [J]. J Surg Oncol, 2005, 91(4): 232236.
23. Kodera Y, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer [J]. Br J Surg, 2005, 92(9): 11031109.
24. Tsujinaka T, Sasako M, Yamamoto S, et al; Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Influence of overweight on surgical complications for gastric cancer: results from a randomized control trial comparing D2 and extended paraaortic D3 lymphadenectomy (JCOG9501) [J]. Ann Surg Oncol, 2007, 14(2): 355361.
25. 周岩冰, 张坚, 李世宽, 等. 胃癌术后并发症多因素Logistic回归分析及风险模型的建立 [J]. 中华普通外科杂志, 2007, 22(3): 164167.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Related Factors of Postoperative Severe Complications in Elderly Patients with Gastric Cancer

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