Risk factors for complications following resection of large gastric cancer

Yasuda, Kazuhiro; Shiraishi, Norio; Adachi, Yosuke; Ito, Masafumi; Sato, Kumi; Kitano, Seigo

doi:10.1046/j.0007-1323.2001.01782.x

Cited by 67 publications

(55 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given that preoperative pulmonary disease may be responsible for higher rates of postoperative pulmonary infection, further preventative treatment strategies should be considered seriously. The role of intraoperative blood loss as a risk factor for postoperative complications has been previously reported by other authors and may be related to blood transfusion, which is said to be associated with immunologic disorders [19][20][21]. Other factors such as age, anemia, hypoalbuminemia, and hyperglycemia, which are generally considered to be associated with higher complication rates, did not appear to be risk factors in this study.…”

Section: Risk Factors For Postoperative Complicationscontrasting

confidence: 33%

See 1 more Smart Citation

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Sah

Zhu

Chen

et al. 2008

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose We investigated the risk factors for early postoperative complications after gastric cancer surgery. Materials and methods The data from a total of 273 patients with gastric cancer were analyzed by univariate and multivariate analysis. We applied physiological and operative severity score for the enumeration of morbidity and mortality (POSSUM) to compare risk-adjusted surgical outcomes among different surgical units. Results Among the preoperative variables, patient gender, chronic obstructive pulmonary disease, surgical unit, and intraoperative blood loss were independent risk factors for a higher rate of postoperative complications. There were significant differences in complication rates among different surgical units (P=0.001). The observed-to-expected morbidity ratio (O-to-E ratio) ranged from 0.81 to 1.63. Units with low surgical work volume had higher complication rates. Postoperative length of stay was significantly shorter (P=0.000) and the rate of moderate and severe complications was significantly lower (P=0.001) in specialized unit.Conclusions POSSUM is a valid system for risk-adjusted evaluation of surgical outcomes. We conclude that surgical experience and work volume greatly influence the outcome, with overall surgical outcome in specialized centers superior to that in other units. Hence, gastric cancer surgery should be performed in specialized centers. Risk factors identified in this study need further confirmation by a prospective study involving a larger cohort.

show abstract

Section: Risk Factors For Postoperative Complicationscontrasting

confidence: 33%

“…The rate of early postoperative complications is relatively high after gastric cancer surgery [10][11][12]. However, in the present study, POSSUM predicted morbidity satisfactorily, which means the surgical outcome was acceptable and was comparable to that in other specialized centers around the world [10,11,[13][14][15].…”

Section: Postoperative Complicationsmentioning

confidence: 78%

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Sah

Zhu

Chen

et al. 2008

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…In hospital mortality rate in our study was 6.12%, which is similar to the postoperative mortality rates of 6 to 10%, found in other studies [8]. The difference between the three groups was not found to be statistically signifi cant (p=0.945).…”

Section: Discussionsupporting

confidence: 88%

Role of gastric bypass in patients with unresectable advanced carcinoma of stomach

2008

View full text Add to dashboard Cite

Context Role of bypass as a palliative surgery for advanced gastric cancer remains controversial.Aims To determine the role of bypass in advanced gastric cancer in comparision to resection as gold standard.Design Hospital-based retrospective outcome as study.Methods Patients were divided into three groups: group I (gastric resection), group II (bypass) and group III (exploratory laparotomy alone). The three groups were analysed for palliation of symptoms, operative morbidity and mortality and survival.Statistical analysis used Chi-square, Fischer, One-way Anova, Unpaired-t, Kaplan-Meier analysis.

show abstract

“…Hodul et al [6] studied in 122 patients with pancreatoduodenectomy, including 48 patients aged over 70 years, and reported no significant difference between older group and younger group comparing the rate of complications, such as wound infection, abdominal abscess, pancreatic leak, and so on. A retrospective study carried out on 97 patients with a gastric tumor measuring 10 cm or more in diameter showed age was not the influencing factor of frequency of complications [5] . Furthermore, analysis of extended hepatectomy (more than four liver segments) demonstrated age was not a contributor to in-hospital mortality [8] .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies suggested that elderly surgical patients had high morbidity and mortality [3,4] . Other reports showed that there was no significant difference in the rate of complications and death between the older and the younger surgical patients [5,6] . Two hundreds and eleven patients undergone major abdominal operations, including hepatectomy, gastrectomy and pancreatoduodenectomy in recent 5 years were analyzed retrospectively to see whether the older patients face more risks than younger patients.…”

Section: Introductionmentioning

confidence: 97%

Safe major abdominal operations: Hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients

Yu²,

Xu³

2004

WJG

View full text Add to dashboard Cite

AIM:To evaluate the impact of advanced age on outcome after hepatectomy, gastrectomy and pancreatoduodenectomy. METHODS:Two hundreds and eleven patients undergone hepatectomy, gastrectomy and pancreatoduodenectomy from January 1998 to September 2002 were analyzed retrospectively. Clinicopathologic features and operative outcome of 83 patients aged 65 years or more were compared with that in 128 younger patients aged less than 65 years. RESULTS:The nutritional state, such as pre-operation level of serum albumin and hemoglobin in the older patients was poorer than that in the younger patients. The older patients had higher comorbidities than the younger patients (48.2% vs 15.6%). No significant difference was observed in perioperative mortality, and complication rate between the older and younger patients (2.4% vs 1.6% and 22.9% vs 20.3%, respectively). Multivariate analysis demonstrated that pancreatoduodenectomy, hepatectomy with resection of more than 2 segments and comorbidities were independent predictors of postoperative complication, whereas age was not (P=0.3172). CONCLUSION:It is safe for patients aged 65 years or more to undergo hepatic, pancreatic and gastric resection if great care is taken during perioperative period.Wu YL, Yu JX, Xu B. Safe major abdominal operations: Hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients. World

show abstract

Risk factors for complications following resection of large gastric cancer

Abstract: Even in Japan, the morbidity of gastrectomy for large gastric cancer is high and associated with operating time, blood loss, pancreatic invasion and serum CEA level.

Cited by 67 publications

References 31 publications

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment

Role of gastric bypass in patients with unresectable advanced carcinoma of stomach

Safe major abdominal operations: Hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients

Contact Info

Product

Resources

About