Document Detail


Complications following D3 gastrectomy: post hoc analysis of a randomized trial.
MedLine Citation:
PMID:  16369704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: A single institutional surgical trial for gastric cancer had demonstrated increased morbidity but not mortality. This report analyzes risk factors affecting morbidity. METHODS: Risk factors for morbidity in 221 patients treated with curative intent were evaluated in a prospective randomized trial comparing D1 and D3 surgery for curable gastric cancer. RESULTS: The surgeon's experience after 25 nodal dissections had no influence on surgical or overall complications, nor did the patients' co-morbidity (e.g., respiratory system disease, cardiac disease, diabetes mellitus). Distal pancreatectomy negatively affected surgical morbidity [relative risk (RR) 6.21, 95% confidence interval (CI) 1.869-20.626] and overall morbidity (RR 5.50, 95% CI 1.671-18.082). All of the patients with a distal pancreatectomy underwent concomitant splenectomy. Multivariate analysis found splenectomy and nodal dissection to be the only two independent risk factors adversely affecting operative morbidity. The RR of splenectomy for surgical complications was 4.19 (95% CI 1.327-13.208), and for overall complications it was 3.88 (95% CI 1.259-11.973). The RR of nodal dissection for surgical complications was 2.51 (95% CI 1.336-4.730), and for overall complications it was 1.93 (95% CI 1.149-3.255). CONCLUSIONS: Splenectomy (with or without pancreatectomy) and nodal dissection are risk factors for operative morbidity but not mortality.
Authors:
Chew-Wun Wu; I-Shou Chang; Su-shun Lo; Mao-Chin Hsieh; Jen-Hao Chen; Wing-Yiu Lui; Jacqueline Whang-Peng
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  30     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-03-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  12-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Taipei Veterans General Hospital, Shi Pai Road, Taipei, 112, Taiwan. cwwu@vghtpe.gov.tw
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MeSH Terms
Descriptor/Qualifier:
Aged
Comorbidity
Female
Gastrectomy* / adverse effects
Humans
Lymph Node Excision
Male
Multivariate Analysis
Pancreatectomy
Risk Factors
Splenectomy
Stomach Neoplasms / epidemiology,  pathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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