Gastric cancer surgery in cirrhotic patients: Result of gastrectomy with D2 lymph node dissection

Table 1 Characteristics of patients, tumors, and surgeries

Patients			Variables
Variables	Number	%
Sex			Age (yr)
Male	73	77.7	Median	59
Female	21	22.3	Range	36-76
Diagnosis of cirrhosis			Retrieved nodes
Preoperative	35	37.2	Median	35
Intraoperative	59	62.8	Range	15-71
Cause of cirrhosis			Positive nodes
HBV-related	52	55.3	Mean	3.5
Alcohol	30	31.9	Range	0-27
HCV-related	8	8.5	Operation time (min)
Cryptogenic	4	4.3	Mean	194.6
Extent of gastric resection			Range	110-345
Subtotal	73	77.7	Hospital stay (d)
Total	21	22.3	Median	13.5
TNM stage			Range	7-90
I	51	54.3
II	25	26.6
III	10	10.6
IV	8	8.5

Table 2 Morbidities and mortalities

	Patients		Total (%)
	No drainage(n = 37, %)	Drainage(n = 57, %)
Morbidities
Absent	27 (73.0)	30 (52.6)	57 (60.6)
Present	10 (27.0)	27 (47.4)	37 (39.4)
Wound infection	2 (5.4)	8 (14.0)	10 (10.6)
Ascending infection	0 (0.0)	3 (5.3)	3 (3.2)
Pneumonia	2 (5.4)	3 (5.3)	5 (5.3)
Bleeding	1 (2.7)	3 (5.3)	4 (4.3)
Anastomosis leakage	1 (2.7)	1 (1.8)	2 (2.1)
Ascites	3 (8.1)	10 (17.5)	13 (13.9)
Mortalities	0 (0.0)	2 (3.8)1	2 (2.1)

¹Mortalities were caused by hepatorenal syndrome.

Table 3 Factors associated with complications

Variables	Complication		P
	Absent (n, %)	Present (n, %)
Sex			0.351
Male	42 (57.5)	31 (42.5)
Female	15 (71.4)	6 (28.6)
Age (yr)			0.138
<55	34 (66.7)	17 (33.3)
≥55	23 (53.4)	20 (46.6)
Causes of cirrhosis			0.188
HBV-related	36 (69.2)	16 (30.8)
Alcohol	14 (46.7)	16 (53.3)
HCV-related	4 (50.0)	4 (50.0)
Cryptogenic	3 (75.0)	1 (25.0)
Anemia (<100 g/L)			0.37
Absent	46 (62.2)	28 (37.8)
Present	11 (55)	9 (45.0)
Thrombocytopenia (<105/U)			0.619
Absent	45 (62.5)	27 (37.5)
Present	12 (54.5)	10 (45.5)
Albumin (g/L)			0.386
≥36	38 (64.4)	21 (35.6)
<36	19 (54.3)	16 (45.7)
Aspartate aminotransferase (IU/L)			0.03
≤40	40 (70.2)	17 (29.8)
>40	17 (63)	20 (37.0)
Bilirubin (mg/dL)			0.819
≤1.4	40 (59.7)	27 (40.3)
>1.4	17 (63)	10 (37.0)
Prothrombin (%)			0.656
≥80	39 (62.9)	23 (37.1)
<80	18 (56.3)	14 (43.7)
Child–Pugh class			0.207
A	52 (63.4)	30 (36.6)
B or C	5 (41.7)	7 (58.3)
Transfusion			<0.001
No	46 (75.4)	15 (24.6)
Yes	11 (33.3)	22 (66.7)
Extent of gastric resection			0.45
Subtotal	46 (63)	27 (37.0)
Total	11 (52.4)	10 (47.6)
Stage			0.835
EGC	26 (61.9)	16 (38.1)
AGC	31 (59.6)	21 (40.4)
Prophylactic drainage			0.055
No	27 (73)	10 (27.0)
Yes	30 (52.6)	27 (47.4)

Table 4 Logistic regression analysis of risk factors for postoperative complication

Covariate (observed value)	Coefficient	SE	RR (95%CI)	P
Causes of cirrhosis	0.9744	0.5543	2.6496 (0.8941-7.8517)	0.079
(Postnecrotic vs others)
GPT (IU/L)	1.3899	0.5446	4.0143 (1.3807-11.672)	0.011
( ≤40 vs >40)
Transfusion	1.6837	0.5	5.3856 (2.0214-14.3485)	0.008
(no vs yes)

SE: standard deviation; RR: relative risk; CI: confidence interval.