Author/Editor		Rumpf, Dean; Jagrič, Tomaž; Hazabent, Marko; Gajzer, Borut; Ivanecz, Arpad; Potrč, Stojan
Title		Zapleti po gastrektomijah zaradi raka želodca
Translated title		Complication after gastrectomy for gastric cancer
Type		članek
Source		In: Potrč S, Hazabent M, Gajzer B, editors. 2. Mariborski onkološki dan: simpozij z mednarodno udeležbo na temo Maligna obolenja želodca; 2009 nov 27; Maribor. Maribor: Oddelek za abdominalno in splošno kirurgijo, Kirurška klinika UKC,
Publication year		2009
Volume		str. 239-58
Language		slo
Abstract		Aim: An 18-year period of surgical treatment of gastric cancer in our institution, its morbidity, mortality and prognostic predictors for complications were retrospectively analyzed in our study. Methods: Since 1992 897 patients were institutionalized in our centre for gastric cancer. The 18-year period was divided into three subsequent periods, in which patient's demographic characteristics, tumor pathohystological characteristics, morbidity and mortality were collected. Results: From 771 operated patients an R0 resection was achieved in 657 (85,2%) patients. In this group 484 (62,8%) were men and 287 (37,2%) were women. The average age was 64,4 years. The total number of complications in the whole period was 186 (24,1%). From this 131 (17%) represented surgical and 69 (8,9%) general complications. There were no significant differences in morbidity regarding the type of resection, extend of lymphadenectomy, tumor size and UICC stage. The significant predictors were only general state of the patient and splenectomy.The cumulative 30 day mortality was 6,5%. The 30 day mortality was with 24% lower in the group of patients with surgical complications than in group of patients with general complications (36%). There were no significant differences in morbidity between periods, however, the ratio surgical to general complications changed in favor of surgical complications, which slightly declined. An insignificant decline was also noted in the 30 day mortality in the last period. The patients, who survived the first 30 postoperative days and had complications, had a shorter survival than patients with no complications. The multivariate analysis identified general state of the patient and splenectomy as the significant predictors for survival. The predictors for serious surgical problems were general state, gender, splenectomy and the number of resected lymph nodes. (Abs. trunc. at 2000 ch.)
Summary		Izhodišča: V študiji smo retrospektivno analizirali 18 letno obdobje kirurškega zdravljenja raka želodca v naši ustanovi, število zapletov in pooperativno umrljivost, zanimali pa so nas tudi neodvisni dejavniki za nastanek zapletov. Metode: Od leta 1992 je bilo na našem centru obravnavanih 897 bolnikov zaradi raka na želodcu. 18 let kirurškega zdravljenja smo razdelili na tri obdobja, beležili demografske značilnosti bolnikov, patohistološke značilnosti tumorjev, pooperativni potek z morebitnimi zapleti in smrtnostjo ter preživetja bolnikov. Rezultati: Od skupno 771 operiranih bolnikov, je bilo mogoče doseči R0 resekcijo pri 657 (85,2%) pacientih. V tej skupini je bilo 484 (62,8%) moških in 287 (37,2%) žensk. Povprečna starost je bila 64,4 let. Skupno število zapletov v celotnem obdobju je bilo 186 (24,1%).Od tega je bilo 131 (17%) kirurških in 69 (8,9%) splošnih zapletov. Morbiditeta se glede na tip resekcije, obseg limfadenektomije, velikost tumorja in UICC stadija ni razlikovala. Bistveno sta na število zapletov vplivala le splošno stanje bolnikov in splenektomija. 30 dnevna mortaliteta za celotno skupino je bila 6,5%. Pri bolnikih s kirurškimi zapleti je le-ta znašala 24% in nekoliko več (36%) pri bolnikih s splošnimi zapleti. Med obdobji se število zapletov ni razlikovalo, spremenil pa se je delež kirurških in splošnih zapletov v prid splošnim zapletom. Opazen je bil tudi nesignifikanten upad 30 dnevne mortalitete v zadnjem obdobju. Bolniki, ki so imeli zaplete in so preživeli 30 dni po operaciji, so imeli bistveno krajše preživetje. Multivariatna analiza je prepoznala splošno stanje in splenektomijo kot neodvisna prediktorja preživetja. Kot dejavnike za težje kirurške zaplete pa so se izkazali splošno stanje, spol, splenektomija in število odstranjenih bezgavk. (Izvl. skrajšan na 2000 zn.)
Descriptors		STOMACH NEOPLASMS GASTRECTOMY MORTALITY