The impact of pancreas compression time during minimally invasive gastrectomy on the postoperative complications in gastric cancer

A postoperative complications rate of nearly 50% has compelled oesophago-gastric practice to adopt minimally invasive techniques such as robotic surgery

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Enhanced recovery after surgery (ERAS) pathway optimizes outcomes and costs for minimally invasive radical prostatectomy

Journal of International Medical Research ◽

10.1177/0300060520920072 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092007

Author(s):

Ying Xu ◽

Ao Liu ◽

Lu Chen ◽

Hai Huang ◽

Yi Gao ◽

...

Keyword(s):

Postoperative Complications ◽

Radical Prostatectomy ◽

Minimally Invasive ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Multivariable Analysis ◽

Conventional Care ◽

Conventional Group ◽

Hospitalization Costs ◽

The Impact

Objective To evaluate the impact of an enhanced recovery after surgery (ERAS) pathway on patients undergoing minimally invasive radical prostatectomy at a single institute. Methods In this retrospective study, 301 patients who underwent laparoscopic or robot-assisted laparoscopic radical prostatectomy from May 2014 to September 2018 were consecutively recruited. Before April 2017, the patients were treated with conventional care; all patients were treated with the ERAS pathway thereafter. The primary outcome was the postoperative length of hospital stay (LOS). The secondary outcomes were hospitalization costs and postoperative complications. Results In total, 138 patients were treated with the ERAS pathway, and the remaining patients underwent conventional care. The postoperative LOS was significantly shorter in the ERAS group than in the conventional group (median, 6 vs. 8 days). The hospitalization costs were also significantly lower in the ERAS group ($4086 vs. $5530). Ten (6.1%) patients in the ERAS group and 17 (12.3%) patients in the conventional group developed postoperative complications. The multivariable analysis showed that ERAS care was a significant independent predictive factor for a shortened LOS and reduced hospitalization costs. Conclusions The ERAS pathway was associated with a shortened LOS and reduced hospitalization costs for patients undergoing minimally invasive radical prostatectomy.

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The Incidence of Postoperative Complications after Gastrectomy Increases in Proportion to the Amount of Preoperative Visceral Fat

Journal of Oncology ◽

10.1155/2019/8404383 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Kazuyuki Okada ◽

Tatsuto Nishigori ◽

Kazutaka Obama ◽

Shigeru Tsunoda ◽

Koya Hida ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Visceral Fat ◽

Visceral Obesity ◽

Continuous Variable ◽

University Hospital ◽

Curative Gastrectomy ◽

Visceral Fat Area ◽

The Impact ◽

The Relationship

Background. Visceral obesity is a risk factor for complications after gastrectomy in patients with gastric cancer. However, it is unclear whether postoperative complications decrease with preoperative reduction of visceral fat without the achievement of a nonobese state. This is because previous studies have performed categorical comparisons of obesity and nonobesity. The current study was performed to estimate the impact of the preoperative visceral fat area (VFA) as a continuous variable on postoperative complications after gastrectomy. Methods. Consecutive patients with gastric cancer who underwent curative gastrectomy between June 2006 and August 2017 at the Kyoto University Hospital were included in this retrospective study. The VFA at the level of the umbilicus was measured using preoperative computed tomography. The relationship between postoperative complications and VFA was investigated with univariate and multivariate analyses. Results. total of 566 patients were included in the study. Their mean VFA was 110 ± 58 cm2, and postoperative complications occurred in 121 patients (21.4%). The larger the VFA (<50, 50–99, 100–149, and ≥150 cm2), the higher the incidence of postoperative complications (11%, 14%, 21%, and 38%, respectively, P<0.001). Multivariate logistic regression analyses showed that the VFA was associated with postoperative complications (odds ratio: 1.009, 95% confidence interval (CI): 1.004–1.013, P<0.001), with an incidence of postoperative complications that was 9% (95% CI: 4%–12%) higher for every 10 cm2 increase in the VFA. Conclusion. The incidence of postoperative complications after gastrectomy increases in proportion to an increase in the preoperative VFA.

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25. The impact of postoperative enteral immunonutrition on postoperative complications and survival in gastric cancer patients

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.06.031 ◽

2016 ◽

Vol 42 (9) ◽

pp. S75

Author(s):

A. Szczepanik ◽

L. Scisło ◽

R. Pach ◽

J. Kulig ◽

P. Brandt ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Cancer Patients ◽

Gastric Cancer Patients ◽

The Impact

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623. The impact of sarcopenia on postoperative complications in gastric cancer patients

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.06.343 ◽

2016 ◽

Vol 42 (9) ◽

pp. S186

Author(s):

A. Paszko ◽

L. Scisło ◽

E. Walewska ◽

K. Brzuszkiewicz ◽

A. Szczepanik ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Cancer Patients ◽

Gastric Cancer Patients ◽

The Impact

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The Impact of Preoperative Low Body Mass Index on Postoperative Complications and Long-term Survival Outcomes in Gastric Cancer Patients

Journal of Gastric Cancer ◽

10.5230/jgc.2018.18.e30 ◽

2018 ◽

Vol 18 (3) ◽

pp. 274 ◽

Cited By ~ 2

Author(s):

Chang Hyun Kim ◽

Seung-Man Park ◽

Jin-Jo Kim

Keyword(s):

Gastric Cancer ◽

Body Mass Index ◽

Postoperative Complications ◽

Cancer Patients ◽

Survival Outcomes ◽

Term Survival ◽

Low Body Mass Index ◽

Gastric Cancer Patients ◽

The Impact

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Role of Postoperative Complications in Overall Survival after Radical Resection for Gastric Cancer: A Retrospective Single-Center Analysis of 1107 Patients

Cancers ◽

10.3390/cancers11121890 ◽

2019 ◽

Vol 11 (12) ◽

pp. 1890 ◽

Cited By ~ 2

Author(s):

Christian Galata ◽

Susanne Blank ◽

Christel Weiss ◽

Ulrich Ronellenfitsch ◽

Christoph Reissfelder ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Overall Survival ◽

Postoperative Complications ◽

Hospital Mortality ◽

Surgical Complications ◽

Multivariable Analysis ◽

Radical Resection ◽

Entire Cohort ◽

The Impact

Background: The aim of this study was to investigate the impact of postoperative complications on overall survival (OS) after radical resection for gastric cancer. Methods: A retrospective analysis of our institutional database for surgical patients with gastroesophageal malignancies was performed. All consecutive patients who underwent R0 resection for M0 gastric cancer between October 1972 and February 2014 were included. The impact of postoperative complications on OS was evaluated in the entire cohort and in a subgroup after exclusion of 30 day and in-hospital mortality. Results: A total of 1107 patients were included. In the entire cohort, both overall complications (p < 0.001) and major surgical complications (p = 0.003) were significant risk factors for decreased OS in univariable analysis. In multivariable analysis, overall complications were an independent risk factor for decreased OS (p < 0.001). After exclusion of patients with complication-related 30 day and in-hospital mortality, neither major surgical (p = 0.832) nor overall complications (p = 0.198) were significantly associated with decreased OS. Conclusion: In this study, postoperative complications influenced OS due to complication-related early postoperative deaths. In patients successfully rescued from early postoperative complications, neither overall complications nor major surgical complications were risk factors for decreased survival.

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Impact of Type of Postoperative Complications on Long-Term Survival of Gastric Cancer Patients: Results From a High-Volume Institution in China

Frontiers in Oncology ◽

10.3389/fonc.2021.587309 ◽

2021 ◽

Vol 11 ◽

Author(s):

Hua-Yang Pang ◽

Lin-Yong Zhao ◽

Hui Wang ◽

Xiao-Long Chen ◽

Kai Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Postoperative Complications ◽

Negative Impact ◽

Infectious Complications ◽

Curative Gastrectomy ◽

Term Survival ◽

Long Term Survival ◽

The Impact

BackgroundThis study aimed to evaluate the impact of postoperative complication and its etiology on long-term survival for gastric cancer (GC) patients with curative resection.MethodsFrom January 2009 to December 2014, a total of 1,667 GC patients who had undergone curative gastrectomy were analyzed. Patients with severe complications (SCs) (Clavien–Dindo grade III or higher complications or those causing a hospital stay of 15 days or longer) were separated into a “complication group.” Univariate and multivariate analyses were performed to reveal the relationship between postoperative complications and long-term survival. A 2:1 propensity score matching (PSM) was used to balance baseline parameters between the two groups.ResultsSCs were diagnosed in 168 (10.08%) patients, including different etiology: infectious complications (ICs) in 111 (6.66%) and non-infectious complications (NICs) in 71 (4.26%) patients. Multivariate analysis showed that presence of SCs (P=0.001) was an independent prognostic factor for overall survival, and further analysis by complication type demonstrated that the deteriorated overall survival was mainly caused by ICs (P=0.004) rather than NICs (P=0.068). After PSM, patients with SCs (p=0.002) still had a significantly decreased overall survival, and the presence of ICs (P=0.002) rather than NICs (P=0.067) showed a negative impact on long-term survival.ConclusionSerious complications, particularly of an infectious type, may have a negative impact on overall survival of GC patients. However, additional multicenter prospective studies with larger sample size are required to verify this issue.

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Impact of Low Skeletal Muscle Mass on Complications and Survival for Gastric Cancer: A Propensity Score Matching Analysis

10.21203/rs.3.rs-614857/v1 ◽

2021 ◽

Author(s):

Zhen Fang ◽

Peijuan Li ◽

Jin Liu ◽

Wei Chong ◽

Fengying Du ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Postoperative Complications ◽

Propensity Score ◽

Propensity Score Matching ◽

Muscle Mass ◽

Laparoscopic Gastrectomy ◽

Skeletal Muscle Mass ◽

Significant Difference ◽

The Impact

Abstract Background: Increasing evidence has indicated that low skeletal muscle mass is linked with cancer prognosis, but existing have shown contrasting results. The purpose of the study is to determine the impact of preoperative low skeletal muscle mass (LSMM) on complications and survival of patients who undergo laparoscopic gastrectomy for gastric cancer (GC).Methods: Patients who undergo laparoscopic gastrectomy for GC were enrolled and third lumbar vertebra psoas muscles index (PMI) was assessed by computer tomography (CT). Using propensity score matching (1:1) to obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, comparing the postoperative complications and 3-year overall survival (OS) between LSMM group and non-LSMM group.Results: A total of 386 patients, 226 were matched for analyses. Compared with the non-LSMM group, the LSMM group manifested significantly shorter 3-year OS (58.14% vs 71.95%, P=0.034). However, the incidence of postoperative complications was no difference between two groups after matching. After stratification based on the pT stage of the tumor, statistically significant difference in the 3-year OS rates of the advance GC cohort between the two groups were observed.Conclusions: LSMM predicts a poor prognosis for patients with advance GC and it is not associated with postoperative complications.

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Open versus minimally invasive total gastrectomy after neoadjuvant chemotherapy: results of a European randomized trial

Gastric Cancer ◽

10.1007/s10120-020-01109-w ◽

2020 ◽

Vol 24 (1) ◽

pp. 258-271

Author(s):

Nicole van der Wielen ◽

Jennifer Straatman ◽

Freek Daams ◽

Riccardo Rosati ◽

Paolo Parise ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Neoadjuvant Chemotherapy ◽

Minimally Invasive ◽

Lymph Nodes ◽

Randomized Trial ◽

Total Gastrectomy ◽

R0 Resection ◽

Western Population ◽

Oncological Safety

Abstract Background Surgical resection with adequate lymphadenectomy is regarded the only curative option for gastric cancer. Regarding minimally invasive techniques, mainly Asian studies showed comparable oncological and short-term postoperative outcomes. The incidence of gastric cancer is lower in the Western population and patients often present with more advanced stages of disease. Therefore, the reproducibility of these Asian results in the Western population remains to be investigated. Methods A randomized trial was performed in thirteen hospitals in Europe. Patients with an indication for total gastrectomy who received neoadjuvant chemotherapy were eligible for inclusion and randomized between open total gastrectomy (OTG) or minimally invasive total gastrectomy (MITG). Primary outcome was oncological safety, measured as the number of resected lymph nodes and radicality. Secondary outcomes were postoperative complications, recovery and 1-year survival. Results Between January 2015 and June 2018, 96 patients were included in this trial. Forty-nine patients were randomized to OTG and 47 to MITG. The mean number of resected lymph nodes was 43.4 ± 17.3 in OTG and 41.7 ± 16.1 in MITG (p = 0.612). Forty-eight patients in the OTG group had a R0 resection and 44 patients in the MITG group (p = 0.617). One-year survival was 90.4% in OTG and 85.5% in MITG (p = 0.701). No significant differences were found regarding postoperative complications and recovery. Conclusion These findings provide evidence that MITG after neoadjuvant therapy is not inferior regarding oncological quality of resection in comparison to OTG in Western patients with resectable gastric cancer. In addition, no differences in postoperative complications and recovery were seen.

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