Background The aim of this study was to evaluate the association of postoperative blood transfusion and anemia with postoperative outcomes in gastric cancer surgery. Methods We enrolled 588 patients who had undergone curative resection for gastric cancer. Input variables for risk assessment consisted of 3 categories: patient demographics, surgical and pathological factors, and anemia-related factors. Postoperative outcomes included 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify risk factors influencing postoperative complications. Results The rate of total complications was 19.0 %. Comorbidity, lowest hemoglobin (Hb) level from the operative day up to postoperative day 7 (LOW-Hb), the percentage of drop in Hb level on postoperative day 2 (POD2-Hb change), and postoperative transfusion were independent risk factors in the multivariate analysis, with LOW-Hb and postoperative transfusion found to be the most significant factors. When LOW-Hb was C9.0 g/dL, postoperative complications were higher in the transfused group than in the non-transfused group (60.0 vs. 14.2 %, respectively, p = 0.024), but when LOW-Hb was\9.0 g/dL, postoperative complications were not different between the 2 groups (44.6 vs. 37.5 %, p = 0.525). ConclusionThe lowest postoperative Hb level and postoperative transfusion were the most significant risk factors for postoperative complications in gastric cancer surgery.

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Purpose: Soft tissue hemangioendothelioma (STHE) is a rare vascular tumor, which has a similar prognosis to borderline malignancy. The disease is poorly understood in pediatric cases because of its low incidence; therefore, we investigated treatment strategies for STHE in children. Methods: We retrospectively analyzed 8 patients with STHE, who were pathologically confirmed between January 1995 and June 2015. The median duration of follow-up was 72 months. Results: Five were male and the median age at the time of surgery was 1.2 years. Six patients presented with a palpable mass, and 2 patients experienced facial paralysis. The median tumor size was 4.0 cm. The following tumor locations were observed head (2 patients), neck (2 patients), chest wall (1 patient), sacrococcyx (1 patient), upper limb (1 patient), and lower limb (1 patient). The patients underwent either microscopic complete resection (R0) (3 patients), macroscopic complete resection (R1) (2 patients), or macroscopic incomplete resection (R2) (3 patients). After histopathological examination, 6 patients were diagnosed with kaposiform hemangioendothelioma (HE), one with retiform HE, and one with epithelioid HE. Postoperative sequelae occurred as gait disturbance, hearing impairment, and vocal cord palsy. Tumor recurrence or regrowth occurred in 4 patients. These patients underwent reoperation and IFN therapy; however, in the patient with epithelioid HE, metastasis to the scalp occurred after these therapies. The patient with the head tumor who underwent R2 resection, underwent resection three more times, but died 11 months after the first surgery. Conclusion: When treating STHE in children, R0 resection should be first considered, but recurrence and metastasis should be monitored depending on the size, pathology, and location of the lesion. When major sequelae are expected, function-preserving surgery could be considered, depending on tumor location, size, and nearby organs.