Impact of Various Types of Comorbidities on the Outcomes of Laparoscopic Total Gastrectomy in Patients with Gastric Carcinoma.
- Author:
Oh JEONG
1
;
Mi Ran JUNG
;
Seong Yeob RYU
Author Information
- Publication Type:Original Article
- Keywords: Stomach neoplasms; Comorbidity; Postoperative complications; Laparoscopy; Gastrectomy
- MeSH: Aged; Cerebrovascular Disorders; Comorbidity*; Diabetes Mellitus; Gastrectomy*; Heart; Hemorrhage; Hepatitis; Humans; Hypertension; Incidence; Laparoscopy; Life Expectancy; Liver Cirrhosis; Lung Diseases; Mortality; Multivariate Analysis; Perioperative Care; Postoperative Complications; Retrospective Studies; Stomach Neoplasms
- From:Journal of Gastric Cancer 2018;18(3):253-263
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. RESULTS: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03–4.64), along with old age and intraoperative bleeding. CONCLUSIONS: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.
