Surgical department profile focused on surgical oncology improves significantly the outcomes of major surgery for gastric cancer
Abstract
Introduction. Gastrectomy for cancer remains a challenge for both the patient and the surgical team. It is regarded as a high-risk surgery with extensive postoperative trauma and significant morbidity and mortality. The experience in the preparation and selection for operative treatment and surgery itself are important factors affecting the outcome. The aim of the study was to analyse, on the basis of the first 6 years of departmental functioning, whether the change in surgical department profile from general to oncological surgery affects the outcome of major surgery for gastric cancer.
Materials and methods. Data collected from 114 consecutive patients that underwent major surgery for gastric cancer in the first 6 years of activity of our department were retrospectively reviewed. The department was created on the basis of a previously existing general surgery unit. There were 87 radical and 27 palliative resections. Total gastrectomy was the most common procedure (84%). The material was divided into 2 groups: patients who underwent surgery during first 3 years of the department’s existence (group I, n = 47) and patients who underwent surgery in the second 3-year period (group II, n = 67).
Results. In the second three-year period we found: a higher mean age of patients (67.7 vs 63.1 years), a higher rate of artificial feeding applied (94% vs 66%), a higher mean number of harvested lymph nodes (21.3 vs 15.9), a lower rate of oesophageal anastomosis leak (0 vs 8.5%) and an improved 2-year survival rate (62.7% vs 44.7%). All of the mentioned differences exceeded the level of statistical significance. Postoperative mortality was 1.5% in group II and 8.5% in group I (p > 0.05).
Conclusion. A surgical department profile focused on surgical oncology improves the outcome of major surgery for gastric cancer.
Keywords: gastric cancergastrectomytreatment outcomepostoperative morbidityperioperative mortality
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