Journal of Minimally Invasive Surgery  2016;19(3):97-101

doi:10.7602/jmis.2016.19.3.97

Evaluation of P-POSSUM as a Risk Prediction Model in Laparoscopic Gastrectomy of Elderly Patients with Gastric Cancer.

Hyo Jung KO 1 ; Ki Hyun KIM ; Si Hak LEE ; Cheol Woong CHOI ; Su Jin KIM ; Chang In CHOI ; Dae Hwan KIM ; Tae Yong JEON ; Dong Heon KIM ; Sun Hwi HWANG

Affiliations

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Keywords

Stomach; Gastric cancer; P-POSSUM

Country

Republic of Korea

Language

Korean

Abstract

PURPOSE: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a validated scoring system for auditing surgical outcomes. However, evaluation of this system has primarily been applied to open surgical techniques. The present study demonstrates the validity of P-POSSUM in predicting morbidity and mortality in the treatment of elderly patients with gastric cancer who underwent curative laparoscopic gastrectomy. METHODS: All patients aged 70 years or over, who underwent curative laparoscopic gastrectomy between January 2014 and January 2015, were collected from our hospital database. A case-note review was used to collate data in terms of clinical and operative factors as described in P-POSSUM. Observed/Estimated ratio of morbidity and 30-day mortality were calculated. RESULTS: Laparoscopic gastrectomy was performed in 101 patients. The mean age was 74.9 years (70~83 years). A significant postoperative morbidity was observed in 20 (19.8%) of 101 patients. There was no 30-day mortality. Using exponential analysis, P-POSSUM predicted morbidity in 22 patients. Thus, O/E ratios for morbidity and mortality were 0.9 and 0, respectively. CONCLUSION: P-POSSUM scoring slightly overestimated predictions of morbidity and mortality. An assessment of its application to laparoscopic gastrectomy of elderly patients with gastric cancer merits further evaluation. Also, laparoscopic gastrectomy was a feasible and safe treatment for elderly patients in terms of P-POSSUM.