Accepted Manuscript Morbidity and Mortality After Total Gastrectomy for Gastric Malignancy Edmund K. Bartlett, MD Robert E. Roses, MD Rachel R. Kelz, MD Jeffrey A. Drebin, MD, PhD Douglas L. Fraker, MD Giorgos C. Karakousis, MD PII:

S0039-6060(14)00115-9

DOI:

10.1016/j.surg.2014.03.022

Reference:

YMSY 3709

To appear in:

Surgery

Received Date: 22 November 2013 Accepted Date: 11 March 2014

Please cite this article as: Bartlett EK, Roses RE, Kelz RR, Drebin JA, Fraker DL, Karakousis GC, Morbidity and Mortality After Total Gastrectomy for Gastric Malignancy, Surgery (2014), doi: 10.1016/ j.surg.2014.03.022. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Revised 1/5/14 Morbidity and Mortality After Total Gastrectomy for Gastric Malignancy

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Department of Surgery, University of Pennsylvania, Philadelphia, PA

*These authors contributed equally to this work.

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Running Title: Morbidity and Mortality of Total Gastrectomy

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Edmund K. Bartlett, MD1*, Robert E. Roses, MD1*, Rachel R. Kelz, MD1, Jeffrey A. Drebin, MD, PhD1, Douglas L. Fraker, MD1, Giorgos C. Karakousis, MD1

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Category: Oncology/Endocrine

All authors have read and approved the manuscript.

Corresponding Author:

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Robert Roses, MD

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The authors declare no funding or conflicts of interest.

Hospital of the University of Pennsylvania

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3400 Spruce St., 4 Maloney, DSE Philadelphia, PA 19147

[email protected] Phone: (215) 662-2068 Fax: (215) 615-0555

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ACCEPTED MANUSCRIPT

Abstract

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Background: Frequent perioperative morbidity and mortality have been observed in randomized surgical studies for gastric cancer. However, specific patient factors associated with morbidity and mortality after total gastrectomy have not been well characterized.

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Methods: The ACS NSQIP database (2005-2011) was queried for all patients with a gastric neoplasm undergoing total gastrectomy. Univariate and multivariate logistic regression analyses were performed to identify factors associated with an increased risk of morbidity or mortality.

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Results: In 1165 patients undergoing total gastrectomy, 416 patients (36%) experienced a complication and 55 died (4.7%) within 30 days of operation. In a reduced multivariate model, age>70, preoperative weight loss, splenectomy, and pancreatectomy were significantly associated with morbidity, while age>70, weight loss, albumin

Morbidity and mortality after total gastrectomy for gastric malignancy using the American College of Surgeons National Surgical Quality Improvement Program database.

Frequent perioperative morbidity and mortality have been observed in randomized surgical studies for gastric cancer, but specific patient factors asso...
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