BACKGROUND/AIMS: The reduction in the incidence of severe postoperative complications has resulted in a significant increase in the survival of patients with gastric cancer. METHODOLOGY: A total of 879 patients undergoing gastrectomy for gastric cancer during the last decade were retrospectively evaluated for postoperative complications, mortality and associated risk factors. RESULTS: The most frequent complications were anastomotic leakage (3.0%) and wound infection (2.8%) followed by the development of pancreatic fistulae (2.2%) and intra-abdominal abscesses (1.5%). Multiple logistic regression analysis identified various independent risk factors including the extent of lymph node dissection (D1D2 vs. D3) for anastomotic leakage (RR 3.6, P<0.05), splenectomy or distal pancreatosplenectomy for pancreatic fistulae (RR 27.4, P<0.0001) and operative time (360 min < or =) for intra-abdominal abscess (RR 4.8, P<0.05). In total, fourteen patients (1.6%, n=879) died from postoperative complications, with 5 patients dying following non-curative gastrectomy (5.6%, n=90). The complications most associated with death were anastomotic leakage (4 patients) and pneumonia (2 patients). CONCLUSIONS: In view of the potential risk of complications, we should carefully evaluate the indications for aggressive lymph node dissection and/or combined resection of neighboring organs as well as non-curative gastrectomy.
BACKGROUND/AIMS: The reduction in the incidence of severe postoperative complications has resulted in a significant increase in the survival of patients with gastric cancer. METHODOLOGY: A total of 879 patients undergoing gastrectomy for gastric cancer during the last decade were retrospectively evaluated for postoperative complications, mortality and associated risk factors. RESULTS: The most frequent complications were anastomotic leakage (3.0%) and wound infection (2.8%) followed by the development of pancreatic fistulae (2.2%) and intra-abdominal abscesses (1.5%). Multiple logistic regression analysis identified various independent risk factors including the extent of lymph node dissection (D1D2 vs. D3) for anastomotic leakage (RR 3.6, P<0.05), splenectomy or distal pancreatosplenectomy for pancreatic fistulae (RR 27.4, P<0.0001) and operative time (360 min < or =) for intra-abdominal abscess (RR 4.8, P<0.05). In total, fourteen patients (1.6%, n=879) died from postoperative complications, with 5 patients dying following non-curative gastrectomy (5.6%, n=90). The complications most associated with death were anastomotic leakage (4 patients) and pneumonia (2 patients). CONCLUSIONS: In view of the potential risk of complications, we should carefully evaluate the indications for aggressive lymph node dissection and/or combined resection of neighboring organs as well as non-curative gastrectomy.
Authors: Leandro Cardoso Barchi; Amir Zeide Charruf; Rodrigo José de Oliveira; Carlos Eduardo Jacob; Ivan Cecconello; Bruno Zilberstein Journal: Transl Gastroenterol Hepatol Date: 2016-12-27
Authors: Chih-Han Kung; Mats Lindblad; Magnus Nilsson; Ioannis Rouvelas; Koshi Kumagai; Lars Lundell; Jon A Tsai Journal: Gastric Cancer Date: 2013-10-09 Impact factor: 7.370
Authors: Ha Woo Yi; Su Mi Kim; Sang Hyun Kim; Jung Ho Shim; Min Gew Choi; Jun Ho Lee; Jae Hyung Noh; Tae Sung Sohn; Jae Moon Bae; Sung Kim Journal: J Gastric Cancer Date: 2013-12-31 Impact factor: 3.720