Surgery often results in “complications” or “sequelae”. The former mainly emphasizes the symptoms caused by surgery, while the latter are symptoms that persist for a considerable period of time after surgery. In other words, complications include symptoms that can be cured and are not considered sequelae; however, there are also symptoms that persist for many years after surgery, which are often referred to as sequelae rather than complications, such as intestinal obstruction.
Among the complications or sequelae, in addition to those common to surgery in general, there are also specific symptoms that vary depending on the site of surgery. In either case, the worst case scenario is “death”. If the tumor is located on the surface of the body, such as breast or skin cancer, there is no risk of fatal surgery except for anesthesia, but surgery on the stomach, lungs, and other internal organs has a high mortality rate.
The level of risk of death from surgery certainly depends on the size of the surgery. However, it is often not easy to determine whether a patient died as a result of surgery, such as in the case of death from postoperative myocardial infarction (because even healthy people can die suddenly from myocardial infarction).
Regarding the mortality rate of surgery, the results of the survey of each hospital throughout Japan are shown below.
Esophageal cancer surgery 2.2%
Stomach cancer surgery 0.5% to 1.2% (1.7% in other surveys)
Colon cancer surgery 1.3%
Pancreatic cancer surgery 3.1%
Liver cancer surgery 1.5%
The survey reports in the United States? The data are shown below.
Esophageal cancer surgery 3.4%
Pancreatic cancer surgery 5.8%
Liver cancer surgery 1.7%
Lung cancer surgery 10.7%
The mortality rate for lung cancer surgery is particularly high because it is a major surgery that requires the removal of an entire unilateral lobe of the lung, so it is not particularly outstanding. The reason for the higher mortality rate for esophageal or pancreatic surgery in the United States than in Japan may be influenced by the patient’s physical condition (e.g., obesity or not, presence or absence of diabetes). Because the Japanese are thinner than Europeans and Americans, they are easier to operate on.
The surgical mortality rate is closely related to age, physical strength, and extent of resection. This is clear from the mortality rate of gastrectomy (radical and partial resection) surgery published by the Central Hospital affiliated with the National Cancer Center (Japanese Journal of clinical Oncology 1998:28:112-115).
50 to 69 years
Total gastrectomy 1.4%
Partial gastrectomy 0.5%
Average 0.8%
Over 80 years of age
Total gastrectomy 9.4%
Partial gastrectomy 0%
Average 3.0%
However, there are still some doubts about the correctness of the data reported in these surveys. The above surveys are not compulsory, so the hospitals that would respond tend to be limited to those that are confident in their surgeries. In fact, as the table shows, the surgical mortality rate for esophageal cancer in Japan is 2.2%, but some experts have stated that the surgical mortality rate for esophageal cancer in Japan “should be around 5% on average nationwide.”