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Postoperative morbidity in elderly patients after gastric cancer surgery

BACKGROUND: Elderly patients have a high risk of adverse outcomes after surgery. Therefore, it is essential to determine the predictive factors for postoperative morbidity in elderly patients undergoing gastric cancer surgery. METHODS: A total of 544 patients who underwent elective gastrectomy for g...

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Detalles Bibliográficos
Autores principales: Wakahara, Tomoyuki, Ueno, Nozomi, Maeda, Tetsuo, Kanemitsu, Kiyonori, Yoshikawa, Takuro, Tsuchida, Shinobu, Toyokawa, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102466/
https://www.ncbi.nlm.nih.gov/pubmed/30174400
http://dx.doi.org/10.20524/aog.2018.0274
Descripción
Sumario:BACKGROUND: Elderly patients have a high risk of adverse outcomes after surgery. Therefore, it is essential to determine the predictive factors for postoperative morbidity in elderly patients undergoing gastric cancer surgery. METHODS: A total of 544 patients who underwent elective gastrectomy for gastric cancer at Yodogawa Christian Hospital between January 2007 and December 2015 were divided into the elderly group (age ≥70 years, n=282) and a control group (age <70 years, n=262). Clinicopathological data from all patients were reviewed. RESULTS: The overall morbidity rates were 24.8% in the elderly group and 13.4% in the control group, indicating a significant difference (P<0.001). The incidence rates of anastomotic leakage (4.6% vs. 1.5%, P=0.039) and cardiovascular complications (2.5% vs. 0%, P=0.01) were significantly higher in the elderly group. A multivariate analysis revealed that a blood loss of ≥320 mL was an independent predictive factor of overall morbidity (P=0.004). A blood loss of ≥219 mL (P=0.025) and American Society of Anesthesiologists (ASA) physical status of 3/4 (P=0.006) were associated with anastomotic leakage and postoperative cardiovascular complications, respectively. CONCLUSIONS: The overall morbidity rate was significantly higher among elderly patients and an intraoperative blood loss of ≥320 mL was a significant predictive factor. In particular, anastomotic leakage and cardiovascular complications were seen with greater frequency among those with a higher blood loss volume and ASA physical status, respectively.