Perioperative Risk Assessment for Gastrectomy by Surgical Apgar Score

Abstract

The oSAS was not found to be a predictive factor for severe complications following gastrectomy in Japanese patients. A slightly modified SAS (i.e. the mSAS) is considered to be a useful predictor for the development of severe complications in elective surgery.

The Surgical Apgar Score in esophagectomy

“…These findings are consistent with previous SAS validation studies in large patient populations, 9,10 other procedures, [11][12][13][14][15][16] and other surgical specialties. [17][18][19] The eSAS was a strong predictor of postoperative complications when treated as a dichotomized, categoric, or continuous variable.…”

“…These variables were incorporated into a 10-point scoring system, referred to as the Surgical Apgar Score (SAS). The SAS has now been externally validated in a number of large patient populations, 9,10 for specific procedures, [11][12][13][14][15][16] and for surgical specialties. [17][18][19] These studies have demonstrated significant predictive value of the SAS for postoperative morbidity and mortality.…”

“…Adjustment of the SAS EBL range has previously been described in validation studies for both gastrectomy and total cystectomy procedures. 11,15 Details of the modified eSAS are shown in Box 1.…”

Evaluation of laparoscopic total gastrectomy for advanced gastric cancer: results of a comparison with laparoscopic distal gastrectomy

“…The present study found that postoperative morbidity significantly differed in the elderly, patients with more comorbidities, and those patients who underwent longer operation time. All of these factors had been reported in the previous studies, but the findings were not the same in those studies [27][28][29][30]. This difference may be due to the difference in the definitions of postoperative complications used, the different extents of lymphadenectomy, and the differences in surgeons' experience with the laparoscopic surgery.…”

“…In 2011, Lee et al [27] first used the Clavien-Dindo system to evaluate the postoperative complications in LDG and open distal gastrectomy. Recently, the incidences of morbidity rates for laparoscopic surgery vary from 11.0 to 25.3 % [27][28][29][30], and the complication rates for LTG are reported to be higher than those for LDG because of technical difficulties. However, in this study, the postoperative morbidity rate in LTG group was 15.1 % and the mortality rate was 0.4 %, which were slightly higher than that in the LDG group, but without statistically significant difference.…”