Modified Clavien-Dindo Classification to Analyze the Risk Factors of Early Complications after Radical Gastrectomy and the Impact of Complications on Long-Term Prognosis

Abstract

Background The modified Clavien-Dindo classification system was employed to investigate the occurrence of early complications along with the related risk factors following a radical gastrectomy procedure, with the view of conducting an analysis into the impact of complications on long-term prognosis. Methods The clinical data of 525 patients who had previously undergone a radical gastrectomy procedure for gastric cancer were analyzed in a retrospective fashion. Results Postoperative hospital stay: Complication group (17.88±8.472) days, severe complications group (23.10±7.594) days, significantly higher than non-complication group (10.26±1.973) days and non-severe complications group (11.47±4.712) days (P=0.000<0.05).Multivariate analysis: age (OR = 1.781, P = 0.013), preoperative comorbidity (OR = 1.765, P = 0.020), blood loss (OR = 2.153, P = 0.001), surgical approach (OR = 3.137, P = 0.000) were identified as an independent risk factor associated with early complications. Blood loss (OR=13.053, P=0.013), type of resection (OR=7.936, P=0.047) and nerve involvement (OR=3.670, P=0.009) were identified to be independent risk factors for severe complications.Severe postoperative complications (HR=1.595, P=0.107) and postoperative complications (HR=1.078, P=0.670) were not independent risk factors affecting the 5-year over survival rate. Conclusion Complications following radical gastrectomy were closely related to age, preoperative comorbidity, blood loss, and surgical approach; severe complications were closely related to blood loss, total gastrectomy, and nerve involvement; complications and severe complications were not found to be independent risk factors associated with long-term survival, that being said, they were significantly prolonged postoperative hospital stay.