Digestive cancer surgery in low-mid income countries: analysis of postoperative mortality and complications in a single-center study

Purpose This study aimed to analyze postoperative and 90-day morbidity and mortality and their risk factors in all digestive cancer curative intent resections of a single digestive surgical department in a low-mid income country. Methods All consecutive patients who underwent a surgical resection fo...

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Bibliographic Details
Published in:	Langenbeck's archives of surgery Vol. 408; no. 1; p. 414
Main Authors:	Sekkat, Hamza, Agouzoul, Hassan, Loudyi, Zineb, Naddouri, Jaouad, El Hamzaoui, Jihane, El Fakir, Samira, Omari, Mohammed, Bakali, Youness, Alaoui, Mouna Mhamdi, Raiss, Mohammed, Hrora, Abdelmalek, Sabbah, Farid
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 21-10-2023
Subjects:	Abdominal Surgery Cardiac Surgery Digestive System Surgical Procedures - adverse effects Female Gastrointestinal Neoplasms - surgery General Surgery Humans Laparoscopy - adverse effects Male Medicine Medicine & Public Health Middle Aged Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Thoracic Surgery Traumatic Surgery Vascular Surgery Digestive cancer Mortality Curative surgery Morbidity Risk factors
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Summary:	Purpose This study aimed to analyze postoperative and 90-day morbidity and mortality and their risk factors in all digestive cancer curative intent resections of a single digestive surgical department in a low-mid income country. Methods All consecutive patients who underwent a surgical resection for digestive cancer with a curative intent between January 1, 2021, and December 31, 2021, were included. This is a retrospective analysis of a prospective cancer surgery database managed during the period. Patterns and factors associated with increased morbidity and mortality were analyzed and presented in tabular and descriptive forms. Results Seventy-six patients were included, 38 (50%) were men with a mean age of 59 years (±13.5). Forty patients (52.63%) had tumors locally advanced, staged CT3–CT4 on preoperative imagery. Thirty-three of our population (43.42%) had laparoscopic surgery (conversion rate at 12.12%). In immediate preoperative, the morbidity rate was 36.84%; among each, 7 patients (9.21%) had serious complications (>2 Clavien-Dindo grade), and mortality rate was 5.26%. At 90 days after surgery, morbidity remained the same, and mortality increased to 7.9%. Risk factors for increased morbidity and mortality were female gender, obesity, high levels of carcinoembryonic antigen, hypoalbuminemia, laparotomy approach, hand sewn anastomosis, prolonged operating time, and wide drainage ( p < 0.05). Conclusions This study provides figures on mortality and morbidity related to digestive cancer curative surgery in a low-mid income country digestive department and discusses risk factors increasing postoperative complications and death.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1435-2451 1435-2451
DOI:	10.1007/s00423-023-03156-0