Complications Following Surgery for Gastric Cancer: Analysis of Prospectively Collected Data

Abstract

Background and Aims: The complication rate after surgery for gastric cancer varies according to the particular definition of morbidity, so it's necessary to report them using a standardized method, the Clavien-Dindo system. The purpose of this study was to prospectively analyze all postgastrectomy complications in patients with gastric adenocarcinoma according to the severity grade using Clavien-Dindo system, in order to identify risk factors for postoperative complications and their prognostic significance on survival. Methods: This study is based on data from 90 consecutive patients who underwent gastrectomy for gastric neoplasia between January 2010 and February 2014 at the same unit. 15 patients were excluded (benign tumors, GISTs, missing data). Complications were categorized according to the Clavien-Dindo classification (uncomplicated patients vs patients classified ≥Grade I). The following risk factors were studied: age, BMI, sex, operation method, extent of resection, duration of surgery, transfusions, TNM staging, and lymph node ratio. Multivariate logistic regression was used to evaluate the association between risk factors and presence of complications. To assess the effect on overall survival, after selection of covariates using backward elimination, the Cox proportional hazard model was applied. L. Bruno et al. 1455Some variables can predict the risk of postoperative complications, the occurrence of which is a predictor of reduced probability of survival. In this respect it's essential to reduce complications.

Complications after appendectomy in patients with treated appendicitis: results from a retrospective study

“…While many other studies have reported only the most common complications (i.e., SSI, IAA, ileus, and postoperative pyrexia) (14,15), we reported complications of any kind that required a form of treatment. To evaluate the severity of the complications, we used Clavien-Dindo classification, which is the most commonly used system for categorizing the severity of complications (16,17). The use of standardized reporting for the type of appendicitis (simple or complex) and complications, including explicit definitions for these complications and their severity, are key factors in improving the comparability of future studies.…”

Postoperative C‐reactive protein concentrations to predict infective complications following gastrectomy for cancer

“…12 Commonly reported infective complications following gastrectomy include intra-abdominal abscess, wound infection, dehiscence, sepsis and pneumonia. 13,14 One of the most serious complications, however, is anastomotic leakage with a reported incidence of 2.1%-14.6% and a mortality rate of up to 50%. 15,16 Postoperative complications are often only diagnosed after the patient develops clinical symptoms or signs, thus requiring further major interventions such as reoperation and unplanned intensive care unit (ICU) admission, prolonging hospital stay, and putting the patient at further risk of additional morbidity or indeed mortality.…”