Morbidity and mortality after abdominal operations for cancer

A review of 316 consecutive patients operated on for intra-abdominal cancer was undertaken to analyze the incidence of postoperative morbidity and mortality and identify contributory factors. The overall postoperative morbidity and mortality after operations performed for primary cancer were, respectively, 26% (75/288) and 7% (20/288), and those seen after operations for recurrent cancer 43% (12/28) and 29% (8/28). Factors that were statistically associated with a fatal outcome were recurrent cancer (p = 0.0005), palliative resection (p = 0.005), a serum albumin level under 35 G/L (p = 0.011) and a weight loss of more than 5 kilograms (p = 0.046); those associated with a significantly greater complication rate were a serum albumin level under 35 G/L (p = 0.000004), a weight loss of more than 5 kilograms (p = 0.00007), intra-abdominal carcinosis (p = 0.0057), and an emergency procedure (p = 0.048). Infective complications were more common among the patients who underwent resective surgery than among those operated on non-resectively. It is concluded that preoperative malnutrition is predictive of both postoperative complications and increased mortality, and that recurrent disease and palliative surgery are associated with high postoperative mortality.