Surgery of Gastric and Colorectal Cancer in the Patient with Psychiatric Disorders

Nobuyoshi Aoyanagi, Minoru Watanabe and Ichiro Iizuka

National Center of Neulorogy and Psychiatry, Kohnodai Hospital

Purpose: Number of psychiatric disorder patients who undergoing medical treatment is increasing in Japan. We retrospectively studied the impact of coexisting psychiatric disorders on the perioperative management of surgery for gastric and colorectal cancer. Patients and Methods: Subjects were consecutive 381 patients undergoing surgery for gastric and colorectal cancer between January 1998 and March 2005. Of these, 61 had psychiatric disorders (disorder group: DG), while, 320 patients did not complicated with psychiatric disorders (non-disorder group: NG). Results: The proportion of patients screened by annual medical checkup was significantly lower in the DG group than in the NG group. Overall morbidity in gastric surgery was 38% in the DG group and 28% in the NG group, and 30% in the DG group and 33% in the NG group in colorectal surgery. Mortality rate was zero in both groups. In gastric surgery, the median postoperative hospital stay was 30.5 days in the DG group and 25 days in the NG group, and in colorectal surgery, 22 days in the DG group and 24 days in the NG group. No significant differences between groups were seen in, morbidity, mortality, or length of postoperative hospitalization. Postoperative intravenous injections of psychotropic drugs, temporary physical restrictions, and resistance to medical treatment were studied as episodes associated to psychiatric complications. These three psychological episodes were significantly higher in the DG group than in the NG group. Conclusions: Although additional response to postoperative psychiatric complications was needed, the perioperative risk of gastrointestinal surgery in psychiatrically disordered patients was essentially equivalent to non-disordered patients.

Key words
psychiatric disorder, gastrointestinal surgery, operative risk

Reprint requests
Nobuyoshi Aoyanagi Department of Surgery, Kohnodai Hospital, National Center of Neurology and Psychiatry
1-7-1 Kohnodai, Ichikawa, Ichikawa, 272-8516 JAPAN

Accepted
October 25, 2006

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