A New Scoring System Using Preoperative Factors and Contour Mapping for Predicting Postoperative Complications of Laparoscopic Gastrectomy

Ohkura, Yu; Shinohara, Hisashi; Shindoh, Junichi; Haruta, Shusuke; Ueno, Masaki; Sakai, Yoshiharu; Udagawa, Harushi

doi:10.1159/000442028

Cited by 8 publications

(3 citation statements)

References 29 publications

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“…The overall rate of postoperative morbidity was similar with those in the prospective JCOG0110, and the current study clarified that splenectomy was associated with significantly higher rate of pancreas-related complications ( p = 0.003) such as pancreatic fistula/abdominal abscess [13, 14]. Mobilization of the pancreas from the retroperitoneum and extensive lymphadenectomy along the splenic vessels may be associated with these clinical results in the splenectomy group [15, 16].…”

Section: Discussionsupporting

confidence: 73%

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature

et al. 2017

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BackgroundFor proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature.MethodsRetrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45).ResultsPatients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072).ConclusionsFor advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

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Section: Discussionsupporting

confidence: 73%

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature

et al. 2017

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“…The operative procedure was either total gastrectomy or distal gastrectomy, with D1+ or D2 lymphadenectomy depending on the degree of progression and surgical risk. [ 9 – 11 ] The reconstruction technique was either Billroth-I or Roux-en Y.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of postoperative intravenous acetaminophen (Acelio) after gastrectomy

Ohkura¹,

Haruta²,

Shindoh³

et al. 2016

Medicine

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The aim of this study was to investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance recovery after gastrectomy.Opioid use is reportedly associated with delayed recovery of gastrointestinal (GI) peristalsis and postoperative nausea/vomiting (PONV) despite of acceptable efficacy for pain control.Of 147 and 96 consecutive patients who underwent gastrectomy for gastric cancer before and after introduction of postoperative scheduled intravenous acetaminophen, propensity score matched population was created and short-term clinical outcomes were compared.Significant defervescence was demonstrated in Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (P < 0.001), whereas no significant difference was observed in postoperative inflammatory parameters. The incidence of postoperative complications was similar between the groups. The number of patient-controlled analgesia (PCA) pushes was significantly reduced in the A-group (P = 0.007) and the frequency of use of other nonopioid analgesics was also significantly reduced in the A-group (P < 0.001). Both daily and cumulative opioid use was significantly reduced in the A-group (P < 0.001). The time to first flatus and defecation was decreased in the A-group (P < 0.001 and P = 0.038, respectively). The incidence of PONV was significantly reduced from 26.0% to 12.5% after introduction of intravenous acetaminophen (P = 0.017), and hospital stay tended to be decreased in the A-group (13.2 vs 14.7 days, P = 0.069)Postoperative scheduled intravenous acetaminophen decreased opioid use and may be associated with enhanced recovery after gastrectomy.

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“…There are two models for predicting the complications of laparoscopic gastric cancer surgery. One is the complication score constructed by Professor Chang-Ming Huang's team at Fujian Medical University Union Hospital[ 12 ], and the other is a scoring system constructed by Ohkura et al 's team at Kyoto University Medical School Hospital in Japan[ 13 ]. Both models have excellent ability to predict complications.…”

Section: Introductionmentioning

confidence: 99%

Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer

Hong,

Yan,

Zhao

et al. 2024

World J Gastroenterol

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BACKGROUND Laparoscopic radical gastrectomy is widely used, and perioperative complications have become a highly concerned issue. AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery, guide perioperative treatment strategies for gastric cancer patients, and prevent serious complications. METHODS In total, 998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model, and 398 patients were included in the validation group. The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected. Three machine learning methods, lasso regression, random forest, and artificial neural networks, were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy, and their prediction efficacy and accuracy were evaluated. RESULTS The constructed complication model, particularly the random forest model, could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy. It exhibited stable performance in external validation and is worthy of further promotion in more centers. CONCLUSION Using the risk factors identified in multicenter datasets, highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established. We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.

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A New Scoring System Using Preoperative Factors and Contour Mapping for Predicting Postoperative Complications of Laparoscopic Gastrectomy

Cited by 8 publications

References 29 publications

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature

Effectiveness of postoperative intravenous acetaminophen (Acelio) after gastrectomy

Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer

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