Risk factors for operative mortality and morbidity in gastric cancer undergoing D2-gastrectomy

Abstract

In these studies, we have observed that our mortality (8.2%) and morbidity (26.5%) rates are in concordance with the data from medical literature, and POSSUM scores are the only parameter in positive statistical correlation with mortality. Preoperative and postoperative resuscitation are of great importance if the patients have POSSUM score >20.

A feasibility study of laparoscopic total gastrectomy for clinical stage I gastric cancer: a prospective multi-center phase II clinical trial, KLASS 03

“…Thus, we used the 18% complication rate as the comparative historical control. To calculate the limitation of non-inferiority, we collected 16 studies on complications after open total gastrectomy published in English for the past 10 years and conducted a metaanalysis [8,9,13,[15][16][17][18][19][20][21][22][23][24][25][26][27]. As a result, the 95% confidence interval of the upper limit was determined to be 26.6%, and Additional treatments were required, such as catheter re-insertion due to dysuria and urinary retention Cardiac Treatments were required due to symptoms of heart failure after surgery, myocardial ischemia, or infarction Systemic infection Symptoms of fever due to infection, increased number of neutrophils, and pathogen cultures from a blood culture examination Local complications Wound Extended hospitalization due to surgical wound infection and additional treatment other than simple disinfection was required Ascites Additional treatments were required due to retention of intraperitoneal fluid or abdominal distension after an abdominal ultrasound examination or tomography Postoperative ileus Fasting more than 7 days after surgery due to enteroplegia or drainage that occurred through the nasogastric tube Abdominal abscess Intra-abdominal abscesses or infected body fluids were found after an abdominal ultrasound examination or tomography such that the additional use of antibiotics or additional treatment was required, such as drainage or reoperation Pancreatic leakage Amylase level in peritoneal fluid discharged through the drainage tube was > 1,000 IU, protein ≥ 3.0 g/dL: amylase and protein levels in peritoneal fluid discharged through the drainage tube were routinely measured on postoperative day 4 Acute pancreatitis Symptoms, such as abdominal pain or fever after surgery, accompanied by abdominal CT results or blood amylase levels greater than three times the normal level Intra-abdominal bleeding Bleeding through the drainage tube installed inside the abdominal cavity and additional treatments required, such as blood transfusion, reoperation, and embolization due to bleeding, confirmed through imaging tests accompanied by a decrease in serum hemoglobin Anastomotic bleeding Additional treatments required, such as transfusion, endoscopic surgery, and reoperation, due to a decrease in plasma hemoglobin level caused by anastomotic bleeding confirmed through endoscopy Anastomotic stenosis Fasting or drainage, endoscopic intervention, and reoperation required due to food discharge difficulties below the anastomotic site after surgery Anastomotic leakage…”

Cáncer gástrico en octogenarios ¿Es viable una cirugía con intención curativa?

“…(4) Los factores predictores para morbimortalidad posoperatoria por cáncer gástrico identificados son el sexo, estadio clínico y la extensión de la gastrectomía. (17)(18)(19) Por ese motivo, se pareó los grupos bajo estas variables. De manera similar, los factores de confusión que podrían afectar los resultados posoperatorios son el estadio clínico, tratamiento adyuvante y comorbilidades.…”

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

“…4 Mortality caused by duodenal stump leakage remains 5% despite advances in surgical techniques, antibiotics, and nutritional support. 3 Among the records of 8033 patients who underwent gastrectomy for gastric adenocarcinoma in a single institute, duodenal stump leakage was observed in 3.1% of 162 patients with complications that required re-operation. 12 Gong DJ et al also described duodenal stump leakage occurred in 3 among 44 patients with postoperative morbidity.…”

“…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.…”