J Minim Invasive Surg.  2016 Sep;19(3):97-101. 10.7602/jmis.2016.19.3.97.

Evaluation of P-POSSUM as a Risk Prediction Model in Laparoscopic Gastrectomy of Elderly Patients with Gastric Cancer

Affiliations
  • 1Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea. hwangsh@pusan.ac.kr
  • 2Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Department of Surgery, Pusan National University Hospital, Pusan, Korea.

Abstract

PURPOSE
The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a validated scoring system for auditing surgical outcomes. However, evaluation of this system has primarily been applied to open surgical techniques. The present study demonstrates the validity of P-POSSUM in predicting morbidity and mortality in the treatment of elderly patients with gastric cancer who underwent curative laparoscopic gastrectomy.
METHODS
All patients aged 70 years or over, who underwent curative laparoscopic gastrectomy between January 2014 and January 2015, were collected from our hospital database. A case-note review was used to collate data in terms of clinical and operative factors as described in P-POSSUM. Observed/Estimated ratio of morbidity and 30-day mortality were calculated.
RESULTS
Laparoscopic gastrectomy was performed in 101 patients. The mean age was 74.9 years (70~83 years). A significant postoperative morbidity was observed in 20 (19.8%) of 101 patients. There was no 30-day mortality. Using exponential analysis, P-POSSUM predicted morbidity in 22 patients. Thus, O/E ratios for morbidity and mortality were 0.9 and 0, respectively.
CONCLUSION
P-POSSUM scoring slightly overestimated predictions of morbidity and mortality. An assessment of its application to laparoscopic gastrectomy of elderly patients with gastric cancer merits further evaluation. Also, laparoscopic gastrectomy was a feasible and safe treatment for elderly patients in terms of P-POSSUM.

Keyword

Stomach; Gastric cancer; P-POSSUM

MeSH Terms

Aged*
Gastrectomy*
Humans
Mortality
Stomach
Stomach Neoplasms*
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