Surgery for digestive malignancies in patients with psychiatric disorders

The psychiatric population has been reported to be accompanied with a higher morbidity and mortality in several situations. However, little is known about the effect of co-morbid psychiatric disorders on surgical risk during major digestive surgery for malignancies. Our purpose in the present study, therefore, was to evaluate the impact of co-morbid psychiatric disorders on the outcome of surgery for digestive malignancies.

We retrospectively reviewed medical records of 568 consecutive patients who underwent hepatectomies, gastrectomies, or colorectal resections between June 1998 and May 2006. Of these, 86 patients had psychiatric disorders (disorder group: DG) and the remaining 482 patients did not (non-disorder group: NG). Postoperative parameters including morbidity, mortality, length of postoperative hospital stay in the surgical ward, and the incidence of psychiatric disorder-associated problems were assessed.

Overall, there was 1 patient who died within 30 days in hospital in the DG and 2 patient deaths in the NG. Thirty complications developed in 24 patients of the DG, whereas 138 complications developed in 129 patients of the NG. There was no significant difference in the morbidity or mortality rate between the two groups. The length of the postoperative hospital stay was also similar between the two groups, and the incidence of psychiatric disorder-associated postoperative problems was about ten times higher in the DG than in the NG.

Patients with psychiatric disorders are not accompanied with excess surgical risk during major surgery for digestive malignancies as compared to patients without psychiatric disorders.