Morbidity and Mortality Associated with Gastrectomy for Gastric Cancer

Abstract

Gastrectomy for cancer as currently practiced carries significant morbidity and mortality. Inclusion of additional major procedures increases these risks. The addition of lymphadenectomy was not associated with increased morbidity or mortality. Strategies are needed to optimize surgical outcomes to ensure delivery of multimodality therapy for advanced-stage disease.

Disección submucosa endoscópica en cáncer gástrico incipiente: experiencia inicial en el Hospital Clínico de la Pontificia Universidad Católica de Chile

“…En ambos casos, la probabilidad de presentar compromiso linfático era baja, probablemente cercana a 6% 17 . Considerando que este porcentaje supera la mortalidad asociada a una gastrectomía 28 se recomendó cirugía a los 2 pacientes. Si bien la biopsia final no demostró metástasis linfáticas en ninguno de los casos, creemos que esta es la conducta que se debe tener hasta no contar con mayor evidencia al respecto, teniendo siempre como primer objetivo la seguridad oncológica de nuestros pacientes.…”

Managing Early and Late Postoperative Complications Following Gastric Surgery

“…In a recent study that used the ACS NSQIP participant use file from 2005 through 2010, overall postgastrectomy serious morbidity occurred in 24 % of patients and the 30-day mortality rate was 4 % [6]. Patients undergoing total gastrectomy had serious morbidity and mortality rates of 29 and 5 %, respectively, and patients undergoing partial gastrectomy had serious morbidity and mortality rates of 20 and 3 %, respectively (Table 17.2).…”

“…Surgical Site Infections Superficial, deep, and organ space infections occur in approximately 6, 1, and 7 %, respectively, of patients undergoing gastrectomy for cancer, with only slightly higher rates of organ space infection in patients undergoing total gastrectomy than in those undergoing subtotal gastrectomy [6]. [6,7].…”

“…[6,7]. Failure to wean from ventilator assistance after 48 h and reintubation occur in 6 % of patients, with higher rates in patients undergoing total gastrectomy.…”

The era of laparoscopic surgery for gastric cancer: what is the present territory and what will be next?

“…A separate problem, however, is that generalizing excellent results of laparoscopic procedures ultimately depend on whether the performance of this procedure can be standardized. The mortality rate for gastric cancer surgery is still high, even for open surgery in the West (11). And according to the United States (US) Graduate Medical Education General Surgery Report from 2012, current US general surgery residency graduates on average performed fewer than five gastrectomy procedures during their 5 years of residency training, suggesting limited exposure to gastric cancer surgery during their training (12).…”