Risk factors for complications during surgical treatment of remnant gastric cancer

Abstract

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.

Surgical Resection of Remnant Gastric Cancer Following Distal Gastrectomy: A Retrospective Clinicopathological Study

“…6,14,[17][18][19]28,40,41 In previous reports, postoperative morbidity and mortality for RGC were 19-47 and 2-13 %, respectively. 6,9,10,17,[41][42][43] In our study, postoperative morbidity and mortality for RGC were 18.9 and 2.5 %, respectively. These were relatively low rates.…”

Is subtotal gastrectomy feasible for the treatment of gastric stump cancer located at the anastomotic site after distal gastrectomy for benign lesions?

“…Previous studies have focused on the clinicopathological characteristics of GSC, and SG has been performed in only some cases [5,7,19]. In this study, SG was performed in 21 patients, and 20 of the 21 patients had tumors located at the anastomotic site of the gastric stump.…”

“…Gastrectomy was frequently performed for benign ulcers two or three decades ago. However, the risk of GSC is closely linked to the interval after the initial gastrectomy [7]. Therefore, GSC will continue to be encountered by surgeons [4,8].…”

Does remnant gastric cancer really differ from primary gastric cancer? A systematic review of the literature by the Task Force of Japanese Gastric Cancer Association

“…Because of extended lymph node metastases and serosal invasion at the time of RGC diagnosis, the patients' prognosis was reported to be poor [9]. Although radical surgery is still the only curative treatment for RGC, such complex surgery remains associated with relatively high rates of morbidity and mortality [10]. Anatomical alterations, intraabdominal adhesions, and the frequent combined resection of other organs render an operation for RGC difficult.…”