Risk factors for operative morbidity and mortality in gastric cancer patients undergoing total gastrectomy

Abstract

AIM:To study the risk factors for morbidity and mortality following total gastrectomy. METHODS: We retrospectively reviewed the records of 125 consecutive patients who underwent total gastrectomy for gastric cancer at the Second Affiliated Hospital of Zhejiang University School of Medicine between January 2003 and March 2008. RESULTS: The overall morbidity rate was 20.8% (27 patients) and the mortality rate was 3.2% (4 patients). Morbidity rates were higher in patients aged over 60 [odds ratio (OR)

Human hybrid endoscopic and laparoscopic management of mass lesions of the foregut (with video)

“…Lesions in the body of the stomach may be amenable to wedge resection; however, antral lesions may require antrectomy with gastroduodenostomy or gastrojejunostomy, and lesions of the gastroesophageal (GE) junction may require total gastrectomy with esophagojejunostomy. Although a wedge resection may have little impact on long-term quality of life, a total gastrectomy is a major resection with morbidity rates of 10% to 50% in the immediate postoperative period, [1][2][3][4][5][6] in-hospital mortality of 1% to 11%, 1-6 and a prolonged postoperative hospital stay of 10 to 20 days. [1][2][3][4]7 After discharge, patients with a subtotal or total gastrectomy may have a significant decrease in quality of life, with nausea, reflux, vomiting, bowel and bladder complaints, fatigue, and dumping syndrome.…”

Repeated Duodenal Stump Perforation Using a Stapling Device Following Subtotal Gastrectomy With Roux-en-Y Reconstruction for Advanced Gastric Cancer: Lessons From a Rare Case

“…12 Gong DJ et al also described duodenal stump leakage occurred in 3 among 44 patients with postoperative morbidity. 2 Once a perforation occurs, duodenal fluids, including bile and pancreatic juice, start to leak into the abdominal cavity. Peritonitis can associate with intra-abdominal bleeding and infection, possibly resulting in death.…”

“…Enteric leakage is a significant complication of the gastroenterological surgery, and duodenal stump leakage is the main cause of postoperative mortality after Billroth II and Rouxen-Y reconstruction following gastrectomy. [1][2][3] Advances in surgical techniques and devices, and nutritional support have reduced mortality due to duodenal stump leakage to approximately 5%, 3,4 but this number could still be improved.…”

Acute Pancreatitis as an Early Complication after Gastric Resection

“…Patient's condition progressively deteriorated and on day 45 after diagnosing AP, he was certified dead. 4. A patient at the age of 51, without any significant medical history, underwent partial gastrectomy with Omega gastrojejunal anastomosis and Braun fistula due to ulcer-induced pyloric stenosis.…”