Increased morbidity rates in patients with heart disease or chronic liver disease following radical gastric surgery

Abstract

Background: The aim of this study was to investigate possible associations between (i) comorbid disease and (ii) perioperative risk factors and morbidity following radical surgery for gastric cancer. Materials and Methods: Consecutive patients (759) undergoing radical gastrectomy and D2 level lymph node dissection for gastric cancer were included. Clinical data concerning patient characteristics, operative methods, and complications were collected prospectively. Results: The morbidity rate for radical gastrectomy was 14.2% (108/759). The most significant comorbid risk factors for postoperative morbidity were heart disease [anticoagulant medication: OR=1.5 (95% CI=0.35-6.6, P=0.53); history without medication: OR=4.0 (95% CI=1.1-14.6, P=0.03); history with current medication: OR=6.7 (95% CI=1.5-29.9, P=0.01)] and chronic liver disease [chronic hepatitis: OR=2.4 (95% CI=0.9-6.5, P=0.07); liver cirrhosis class A: OR=8.4 (95% CI=2.8-25.3, P=0.00); liver cirrhosis class B: OR=9.38 (95% CI=0.7-115.5, P=0.08)]. The most significant perioperative risk factors for postoperative morbidity were high TNM stage and combined organ resection (P<0.05), and there was no association between increased postoperative morbidity and well controlled hypertension, anticoagulant therapy, diabetes mellitus, pulmonary disease, tuberculosis, or thyroid disease (P>0.05). Conclusion: Patients with heart disease or chronic liver disease are at a higher risk of morbidity following radical surgery for gastric cancer. © 2010 Wiley-Liss, Inc.