Postoperative Complications and Their Risk Factors of Completion Total Gastrectomy for Remnant Gastric Cancer Following an Initial Gastrectomy for Cancer.

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Sin Hye Park, Sang Soo Eom, Bang Wool Eom, Hong Man Yoon, Young-Woo Kim, Keun Won Ryu
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引用次数: 1

Abstract

Purpose: Completion total gastrectomy (CTG) for remnant gastric cancer (RGC) is a technically demanding procedure and associated with increased morbidity. The present study aimed to evaluate postoperative complications and their risk factors following surgery for RGC after initial partial gastrectomy due to gastric cancer excluding peptic ulcer.

Materials and methods: We retrospectively reviewed the data of 107 patients who had previously undergone an initial gastric cancer surgery and subsequently underwent CTG for RGC between March 2002 and December 2020. The postoperative complications were graded using the Clavien-Dindo classification. Logistic regression analyses were used to determine the risk factors for complications.

Results: Postoperative complications occurred in 34.6% (37/107) of the patients. Intra-abdominal abscess was the most common complication. The significant risk factors for overall complications were multi-visceral resections, longer operation time, and high estimated blood loss in the univariate analysis. The independent risk factors were multi-visceral resection (odds ratio [OR], 2.832; 95% confidence interval [CI], 1.094-7.333; P=0.032) and longer operation time (OR, 1.005; 95% CI, 1.001-1.011; P=0.036) in the multivariate analysis. Previous reconstruction type, minimally invasive approach, and current stage were not associated with the overall complications.

Conclusions: Multi-visceral resection and long operation time were significant risk factors for the occurrence of complications following CTG rather than the RGC stage or surgical approach. When multi-visceral resection is required, a more meticulous surgical procedure is warranted to improve the postoperative complications during CTG for RGC after an initial gastric cancer surgery.

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残胃癌全胃切除术后并发症及危险因素分析。
目的:完全性全胃切除术(CTG)治疗残胃癌(RGC)是一项技术要求高且发病率高的手术。本研究旨在评价胃癌(不含消化性溃疡)行胃部分切除术后RGC术后并发症及其危险因素。材料和方法:我们回顾性回顾了2002年3月至2020年12月期间107例患者的数据,这些患者先前接受了最初的胃癌手术,随后接受了RGC的CTG。术后并发症采用Clavien-Dindo分级。采用Logistic回归分析确定并发症的危险因素。结果:术后并发症发生率为34.6%(37/107)。腹内脓肿是最常见的并发症。在单因素分析中,总并发症的重要危险因素是多脏器切除、较长的手术时间和高的估计出血量。独立危险因素为多脏器切除(优势比[OR], 2.832;95%置信区间[CI], 1.094-7.333;P=0.032)且手术时间较长(OR, 1.005;95% ci, 1.001-1.011;P=0.036)。以往的重建类型、微创入路和目前的阶段与总体并发症无关。结论:多脏器切除和手术时间长是CTG术后并发症发生的重要危险因素,而非RGC分期或手术入路。当需要多脏器切除时,需要更细致的外科手术,以改善初次胃癌手术后RGC CTG的术后并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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