Increased Morbidity Rates in Patients With Heart Disease or Chronic Liver Disease Following Radical Gastric Surgery


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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.

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