In order to identify the risk factors for early complications following total gastrectomy for gastric cancer, we retrospectively revised the medical records of 74 patients during last 8 years. Any pulmonary complications requiring an intervention, anastomotic leakage, intraabdominal abscess, ascites, and hemorrhage were defined as major complication. We determined the risk factors related to the early morbidity by comparing the patients' age, gender, ASA status; operative characteristics such as operating time, reconstruction type of esophagojejunostomy, concomitant organ resection, and transfusion requirement, using a logistic regression analysis.
Overall complication rate was 39% (29 patients). Of these, 41 % were major such as anastomotic leakage in 5 patients, which was fatal in one patient, hemorrhage in one and pulmonary complications necessitating an invasive procedure in remaining 6 patients. ASA score>2, intraoperative transfusion, extra organ resection, type of reconstruction, preoperative albumin level<3 mg/dL were the significant prognostic factors. In regression analysis, blood transfusion (p=0,001 Odds Ratio (OR): 12,15), ASA score greater than 2 (p=0,01 OR: 6,60), and extra organ resection (p=0,03 OR: 4,57) were significant risk factors. These results suggest that patients' preoperative anemia and preexisting medical condition, or operative characteristics such as perioperative blood loss, and concomitant organ resection seem to be important in predicting early complication after total gastrectomy for gastric cancer.
Keywords: Total Gastrectomy, Gastric Cancer, Complication, Morbidity, Postoperative Outcome, Transfusion
