BACKGROUND: Prevention of fatal postoperative complications and improved management of patients with complications are important means of increased survival in gastric cancer patients. PATIENTS AND METHODS: A study of 700 patients undergoing gastrectomy was performed to examine factors that contributed to a high rate of postoperative complications. RESULTS: Of 700 patients undergoing gastrectomy for adenocarcinoma, 40 (5.7%) underwent reexploration because of serious complications. The frequency of the relaparotomies varied from 2.1% and 4.4% after regular subtotal and total gastrectomies, respectively, to 20% and 30.4% after palliative and conventional total gastrectomies, respectively. The complications that required reexploration most frequently were anastomotic leakage and incompetence of sutures (11, 27.5%), intra-abdominal abscesses (8, 20%), and pancreatic necrosis (7, 17.5%). A combination of preventive measures allowed the attainment of low rates of esophagojejunal anastomotic leakage (0.8%). CONCLUSION: We believe that the decision to perform an urgent reexploration, based on clinical findings, should generally be made by a group of experienced surgeons (not only the primary surgeon). Timely relaparotomy prevented death in 37.5% of the patients with serious acute postoperative complications.
BACKGROUND: Prevention of fatal postoperative complications and improved management of patients with complications are important means of increased survival in gastric cancerpatients. PATIENTS AND METHODS: A study of 700 patients undergoing gastrectomy was performed to examine factors that contributed to a high rate of postoperative complications. RESULTS: Of 700 patients undergoing gastrectomy for adenocarcinoma, 40 (5.7%) underwent reexploration because of serious complications. The frequency of the relaparotomies varied from 2.1% and 4.4% after regular subtotal and total gastrectomies, respectively, to 20% and 30.4% after palliative and conventional total gastrectomies, respectively. The complications that required reexploration most frequently were anastomotic leakage and incompetence of sutures (11, 27.5%), intra-abdominal abscesses (8, 20%), and pancreatic necrosis (7, 17.5%). A combination of preventive measures allowed the attainment of low rates of esophagojejunal anastomotic leakage (0.8%). CONCLUSION: We believe that the decision to perform an urgent reexploration, based on clinical findings, should generally be made by a group of experienced surgeons (not only the primary surgeon). Timely relaparotomy prevented death in 37.5% of the patients with serious acute postoperative complications.
Authors: A Gil-Rendo; J L Hernández-Lizoain; F Martínez-Regueira; A Sierra Martínez; F Rotellar Sastre; M Cervera Delgado; V Valentí Azcarate; C Pastor Idoate; J Alvarez-Cienfuegos Journal: Clin Transl Oncol Date: 2006-05 Impact factor: 3.405
Authors: Ra Ri Cha; Sang Soo Lee; Hyunjin Kim; Hong Jun Kim; Tae-Hyo Kim; Woon Tae Jung; Ok Jae Lee; Kyung Soo Bae; Sang-Ho Jeong; Chang Yoon Ha Journal: World J Gastroenterol Date: 2015-04-28 Impact factor: 5.742
Authors: Stuart G Marcus; Daniel Cohen; Ke Lin; Kwok Wong; Scott Thompson; Adina Rothberger; Milan Potmesil; Spiros Hiotis; Elliot Newman Journal: J Gastrointest Surg Date: 2003-12 Impact factor: 3.267