Abstract
Background This study aimed to evaluate the severity of intraoperative and post operative complications of gastric cancer surgery and to investigate the predictive factors correlated to surgical morbidity. Methods We included 145 patients operated for gastric cancer. We investigated the risk factors associated with complications, length of hospital stay, operative time, and intraoperative blood transfusion (BT). Significant risk factors were analyzed by multiple logistic regression analysis. Results Postoperative complications occurred in 32 patients (22.1 %) and the rate of major complications was 7.6%. The rate of anastomotic fistula was 6.9% and was correlated to diabetes, tumor size, operative time, surgical margin, and extended lymphadenectomy. The mean risk factors for postoperative morbidity were the presence of comorbidities and ASA score (p = 0.021), intraoperative BT (p = 0.045) and prolonged operative time (p = 0.055). Conclusion surgical morbidity of gastric cancer is correlated to the extent of resection as well as the clinical and histological characteristics.
Highlights
This study aimed to evaluate the severity of intraoperative and post-operative complications of gastric cancer surgery and to investigate the predictive factors correlated to surgical morbidity
We found that the mean operative time was significantly longer with total gastrectomy compared to partial gastrectomy (204.16mnvs 182.56mn respectively, p=0.015), multi-organ resection (215mn vs 187.60mn, p=0.021), D2 dissection compared to D1 / D1.5 dissection (204.02mm vs 188.61mn respectively, p= 0.004) and in case of splenectomy or splenopancreatectomy (p = 0.037)
We found that the mean risk factors for postoperative morbidity were the presence of comorbidities (p = 0.021), intraoperative blood transfusions (p = 0.045) and prolonged operative time (p = 0.055)
Summary
This study aimed to evaluate the severity of intraoperative and post-operative complications of gastric cancer surgery and to investigate the predictive factors correlated to surgical morbidity. Management of gastric cancer has undergone in the last decade remarkable progress both in the neo-adjuvant and adjuvant treatments and in the surgical procedure as regards the extent of resection and the lymph node dissection These advances are certainly associated with an improvement in the overall prognosis of the neoplastic disease. To limit the subjectivity in the analysis of the complications, many authors used the Clavien and Dindo classification of postoperative complications published in 2004 This classification seems more straightforward, objective, but above all reproducible, since it evaluates the severity of the complications according to their therapeutic management.[2] This study aimed to assess the severity of intraoperative and postoperative complications of gastric surgery and to investigate the predictive factors correlated to surgical morbidity
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