PURPOSE: To promote proper management of postoperative bleeding, we investigated the clinical manifestations, predisposing factors, diagnostic approaches, and treatments of bleeding complications after gastric cancer surgery. METHODS: Using a prospectively constructed database, we reviewed retrospectively 39 patients who suffered bleeding complications from among a total 1027 patients who underwent surgery for gastric cancer between 2004 and 2008. RESULTS: Operating time (hazard ratio [HR] 1.842, 95% confidence interval [CI] 1.524-2.367) and body mass index (HR 1.454, 95% CI 1.128-1.792) were significant predisposing factors for postoperative bleeding after gastric cancer surgery. Luminal bleeding occurred in 16 patients: as simple anastomosis site bleeding, treated successfully with conservative or endoscopic treatment, in 13; and as pseudoaneurysmal bleeding in 3, treated successfully with surgery in 2, but resulting in the death of 1. Abdominal bleeding occurred in 23 patients, requiring surgery in 9 and arterial embolization in 1. The most common finding at reoperation was bleeding from the mesocolon surface. The mean hospital stay of patients with postoperative bleeding was 21 (± 20) days. CONCLUSIONS: Postoperative bleeding can be managed successfully with a tailored approach, considering its origins and clinical manifestations. Arterial pseudoaneurysms are a rare cause of luminal bleeding, but they can be fatal and should be suspected when extensive luminal bleeding presents after gastric cancer surgery.
PURPOSE: To promote proper management of postoperative bleeding, we investigated the clinical manifestations, predisposing factors, diagnostic approaches, and treatments of bleeding complications after gastric cancer surgery. METHODS: Using a prospectively constructed database, we reviewed retrospectively 39 patients who suffered bleeding complications from among a total 1027 patients who underwent surgery for gastric cancer between 2004 and 2008. RESULTS: Operating time (hazard ratio [HR] 1.842, 95% confidence interval [CI] 1.524-2.367) and body mass index (HR 1.454, 95% CI 1.128-1.792) were significant predisposing factors for postoperative bleeding after gastric cancer surgery. Luminal bleeding occurred in 16 patients: as simple anastomosis site bleeding, treated successfully with conservative or endoscopic treatment, in 13; and as pseudoaneurysmal bleeding in 3, treated successfully with surgery in 2, but resulting in the death of 1. Abdominal bleeding occurred in 23 patients, requiring surgery in 9 and arterial embolization in 1. The most common finding at reoperation was bleeding from the mesocolon surface. The mean hospital stay of patients with postoperative bleeding was 21 (± 20) days. CONCLUSIONS:Postoperative bleeding can be managed successfully with a tailored approach, considering its origins and clinical manifestations. Arterial pseudoaneurysms are a rare cause of luminal bleeding, but they can be fatal and should be suspected when extensive luminal bleeding presents after gastric cancer surgery.
Authors: G Piffaretti; M Tozzi; G Carrafiello; R Caronno; D Laganà; C Recaldini; P Castelli Journal: J Cardiovasc Surg (Torino) Date: 2008-10 Impact factor: 1.888
Authors: M Degiuli; M Sasako; M Calgaro; M Garino; F Rebecchi; M Mineccia; D Scaglione; D Andreone; A Ponti; F Calvo Journal: Eur J Surg Oncol Date: 2004-04 Impact factor: 4.424
Authors: Kichang Han; Bestun Mustafa Ahmed; Man-Deuk Kim; Jong Yun Won; Do Yun Lee; Gyoung Min Kim; Joon Ho Kwon; Sung Il Park; Sung Hoon Noh; Woo Jin Hyung Journal: Gastric Cancer Date: 2017-02-13 Impact factor: 7.370
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