Patient selection: total gastrectomy for malignancy
Morbidities included: pneumonia, sepsis, surgical site infection, bleeding, deep vein thrombosis, urinary tract infection, cardiac disease, renal failure, neurologic disorder, intra-abdominal abscess
Risk factors for morbidity:
(1) age > 70 years of age
(2) preoperative weight loss > 10% in past 6 months
(3) splenectomy
(4) pancreatectomy
Risk factors for mortality:
(1) age > 70 years of age
(2) serum albumin < 3.0 g/dL
(3) preoperative weight loss > 10% in past 6 months
(4) pancreatectomy
With no risk factors the morbidity was 26% and mortality rate 0.4%.
If a splenectomy and/or pancreatectomy was performed the morbidity was 56%. If a pancreatectomy was performed the mortality was 13%.
The risk for morbidity and mortality increase with the number of risk factors present.
|
Morbidity Items 1 and 2
|
Morbidity
|
|
0
|
26%
|
|
1
|
39%
|
|
2
|
46%
|
|
Mortality Items 1, 2 and 3
|
Mortality
|
|
0
|
0.4
|
|
1
|
6%
|
|
2
|
10%
|
|
3
|
56%
|
