Multivariate Analysis of Risk Factors for Pulmonary Complications After Hepatic Resection

Nobili, Cinzia; Marzano, Ettore; Oussoultzoglou, Elíe; Rosso, Edoardo; Addeo, Pietro; Bachellier, Philippe; Jaeck, Daniel; Pessaux, Patrick

doi:10.1097/sla.0b013e3182485857

Cited by 100 publications

(95 citation statements)

References 48 publications

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“…In our series 19 (9%) glissonian resections and 16 (7.5%) parenchymal liver resections were performed and hepatic surgery was an independent predictor of overall (G1-G4) complications but only two patients suffered a severe anemization after multiple liver resections. Furthermore, in accordance with literature [22], our data suggest an independent correlation between hepatic surgery and pleural effusion (OR: 2; CI-95: 1.08-3.79;p = 0.026). Reactive pleural effusion is the result of diaphragmatic injury, obstruction of thoracic venous or lymphatic systems, or surgical manipulation on the hepatic coronary ligament (usually causing a subphrenic fluid collection).…”

Section: Discussionsupporting

confidence: 94%

Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery

Panici

Donato

Fischetti

et al. 2015

Gynecologic Oncology

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Section: Discussionsupporting

confidence: 94%

Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery

Panici

Donato

Fischetti

et al. 2015

Gynecologic Oncology

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“…Blood transfusion and obesity are known risk factors for the development of postoperative complications in general surgery as well as in gastric surgery [18][19][20][21]. Our study confirmed this, and further revealed that previous operation-related factors such as anastomosis type and the indication for initial gastrectomy have no impact on the risk of developing complications.…”

Section: Discussionsupporting

confidence: 78%

Risk factors for complications during surgical treatment of remnant gastric cancer

et al. 2014

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Background Surgical treatment for remnant gastric cancer is related to high mortality and morbidity. The aim of this study was to identify risk factors that predispose to postoperative complications after gastrectomy for remnant gastric cancer. Methods A total of 210 patients who underwent a gastrectomy for remnant gastric cancer between January 1998 and December 2012 were retrospectively analyzed. Surgical complications were reviewed and graded using the Clavien-Dindo classification. Univariate and multivariate analysis was performed to identify the risk factors for development of complications. Results The incidence of postoperative complications was 46 % (96/210), and major complications occurred in 14 % (30/210). The operation-related mortality rate was 1.0 %. Multivariate analysis revealed that only a BMI C25 (P = 0.001) and blood transfusion (P \ 0.001) were significant independent risk factors for major complication. Indication for the initial gastrectomy and previous anastomosis type were not related to the development of surgical complications. Conclusions Although surgery for remnant gastric cancer is a complex procedure because of the previous operation, factors related to the previous operation do not affect the development of postoperative complications.

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“…However, the subsequent morbidity and mortality rates remained acceptable, and the overall rate of major medical morbidity was high with a large prevalence of pulmonary complications. Clearly, the challenge remains in the length and complexity of the operation, the type of extended incision required, the high rate of intraoperative transfusions and the use of neoadjuvant chemotherapy [20]. Even if one reasonably considers the observed postoperative morbidity and mortality in the present cohort of patients in view of the extent of surgery, it clearly exceeds that reported by us and others for standard pancreatectomies [21,22,23].…”

Section: Discussioncontrasting

confidence: 47%

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

et al. 2015

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Objective: To report the outcomes of surgical resection of borderline resectable (BL) and locally advanced (LA) ‘unresectable' pancreatic cancer after neoadjuvant chemotherapy. Methods: A review of a prospectively maintained database for pancreatic resections was undertaken to identify patients undergoing resection for BL and LA pancreatic cancer after neoadjuvant chemotherapy between January 2007 and December 2012. Clinicopathological, surgical and survival outcomes were analyzed. Results: A total of 45 patients with LA (n = 34) or BL cancer (n = 11) underwent surgery after a mean (± SD) of 7 ± 4 preoperative chemotherapy cycles. Ninety-day mortality was 6.7%, and overall morbidity was 33.3%. An R0 resection was achieved in 34 patients, and 4 patients showed a complete pathological response. Overall median postoperative survival was 17 months (21 after the start of neoadjuvant treatment). Overall and disease-free survival was 74.9 and 43.6% at 1 year and 21.2 and 10.3% at 3 years, respectively. In BL cancer patients, the 3-year survival was significantly higher compared to that of LA cancer patients (p = 0.02). Conclusions: Curative intent resection in BL and LA cancer patients after neoadjuvant chemotherapy can be achieved with reasonable mortality and morbidity and an encouraging 3-year survival. After neoadjuvant therapy, resection provides a better overall survival for BL compared to LA cancer patients.

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Multivariate Analysis of Risk Factors for Pulmonary Complications After Hepatic Resection

Abstract: The correction of modifiable risk factors among the identified factors could reduce the incidence of PPCs and, as a consequence, improve patient outcomes and reduce the length of hospital stays.

Cited by 100 publications

References 48 publications

Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery

Predictors of postoperative morbidity after cytoreduction for advanced ovarian cancer: Analysis and management of complications in upper abdominal surgery

Risk factors for complications during surgical treatment of remnant gastric cancer

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

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