Background
Methods
Patients
Surgical procedure and extent of lymphadenectomy
Risk assessment
Definition of postoperative morbidity
Results
median age | 65 y | range (38 – 85 y) |
---|---|---|
gender: m:f | 3:2 | |
pT-categ ory
| n = 137 |
%
|
pT1 | 28 | 20, 4 |
pT2 | 46 | 33, 6 |
pT3 | 52 | 38, 0 |
pT4 | 11 | 8,0 |
pN-categ ory
| n = 137 |
%
|
pN0 | 47 | 34, 3 |
pN+ | 90 | 65, 7 |
pM0 | n = 108 | 78, 8 % |
UICC-stage
|
n = 137
|
%
|
Stage IA | 20 | 14, 6 |
Stage IB | 23 | 16, 8 |
Stage II | 27 | 19, 6 |
Stage IIIA | 15 | 11, 0 |
Stage IIIB | 9 | 6, 6 |
Stage IV | 43 | 31, 4 |
Location of tumour
|
n = 137
| % |
Upper third | 67 | 48, 9 |
Middle third | 29 | 21, 2 |
Distal third | 41 | 29, 9 |
Postoperative course
total
|
Postoperative Course
| |||||
---|---|---|---|---|---|---|
1
|
2
|
3
|
4
| |||
Surgical complications
|
n
|
%
|
n
|
n
|
n
|
n
|
Relaparotomy | 5 | 3.6 | - | 1 | 2 | 2 |
Perforation | 2 | 1.5 | - | 1 | - | 1 |
Anastomic leakage | 7 | 5.1 | 1 | 3 | 2 | 1 |
secondary | 1 | 0.7 | - | 1 | - | - |
haemorrhage | ||||||
Ileus | 2 | 1.4 | - | - | 1 | 1 |
Pancreatitis | 5 | 3.6 | - | - | 3 | 2 |
Peritonitis | 5 | 3.6 | - | 1 | 1 | 3 |
Wound infection | 8 | 5.8 | 2 | 1 | 2 | 3 |
Abscess | 3 | 2.2 | - | 1 | 1 | 1 |
Pancreatic fistula | 13 | 9.4 | 1 | 8 | 4 | - |
Catheter infection | 5 | 3.6 | - | 2 | 3 | - |
Systemic complications
| ||||||
Reanimation | 6 | 4.4 | - | - | 2 | 4 |
Sepsis | 7 | 5.1 | - | 1 | 2 | 4 |
pulmonary compl. | 22 | 16.0 | 2 | 7 | 9 | 4 |
cardiac compl. | 23 | 16.8 | 2 | 4 | 10 | 7 |
renal compl. | 5 | 3.6 | 1 | 1 | 1 | 2 |
cerebral compl. | 6 | 4.4 | 1 | 2 | 2 | 1 |
Other compl. | 10 | 7.3 | 6 | 2 | 2 | 0 |
POSSUM-Score
Possum Mortality Risk (R1) | patients | expected death | observed death outcome = 4 | Observed morbidity and death outcome = 3+4 | |||
---|---|---|---|---|---|---|---|
(%) | n | n | n | % | n | % | |
0–10 | 21 | 1 | 0 | 0 | 3 | 14,3 | |
38675 | 51 | 7 | 1 | 2,0 | 7 | 13,7 | |
low risk
|
0 – 20
|
72
|
1
|
1, 0
|
10
|
13, 9
| |
21–30 | 38 | 9 | 3 | 7,8 | 9 | 23,7 | |
31–40 | 19 | 6 | 2 | 10,5 | 4 | 21,1 | |
med risk
|
21–40
|
57
|
5
|
8, 8
|
13
|
22, 8
| |
41–60 | 4 | 1 | 1 | 25,0 | 1 | 25,0 | |
71–100 | 4 | 2 | 1 | 25,0 | 3 | 75,0 | |
high risk
|
> 40
|
8
|
2
|
25, 0
|
4
|
50, 0
| |
total
|
137
|
29
|
8
|
27
|
POSSUM Risk of Morbidity R2 | Patients | Expected morbidity | observed severe morbidity and mortality Outcome (3 + 4) | observed morbidity and mortality Outcome (2 – 4) | |||
---|---|---|---|---|---|---|---|
% | n | n | n | % | n | % | |
0 – 30 | 2 | 0 | 0 | 0 | 0 | 0 | |
31 – 40 | 12 | 3,9 | 3 | 25,0 | 4 | 25,0 | |
41 – 50 | 14 | 6,6 | 1 | 7,1 | 2 | 14,3 | |
50 – 60 | 19 | 10,6 | 2 | 10,5 | 3 | 15,8 | |
low risk
|
0 – 60
|
47
|
6
|
12, 8
|
9
|
19, 1
| |
61 – 70 | 21 | 14,9 | 2 | 9,5 | 8 | 38,1 | |
71 – 80 | 35 | 25,7 | 7 | 20,0 | 14 | 40,0 | |
81 – 90 | 28 | 22,4 | 7 | 25,0 | 10 | 35,7 | |
91–100 | 6 | 5,7 | 5 | 83,3 | 6 | 100,0 | |
high risk
|
> 60
|
90
|
21
|
23, 3
|
38
|
43, 3
| |
Total | 137 | 27 | 47 |