Incidence and risk factors of postoperative complications after robotic gastrectomy for gastric cancer: an analysis of 817 cases based on 10-year experience in a large-scale center

2021 ◽  
Author(s):  
Zheng-yan Li ◽  
Yong-liang Zhao ◽  
Feng Qian ◽  
Bo Tang ◽  
Jun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Postoperative Complications ◽  
Large Scale ◽  
Robotic Gastrectomy

Risk factors for surgical complications after D2 gastrectomy following neoadjuvant chemotherapy for gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 164-164
Author(s):  
Takaki Yoshikawa ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Kazuaki Tanabe ◽  
Kazuhiro Nishikawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Risk Factor ◽  
Postoperative Complications ◽  
Phase Ii ◽  
Surgical Complications ◽  
Phase Ii Trial ◽  
D2 Gastrectomy ◽  
Randomized Phase Ii ◽  
D2 Surgery

164 Background: The feasibility and safety of D2 surgery following neoadjuvant chemotherapy (NAC) has not yet been fully evaluated in patients with gastric cancer. Moreover, the risk factors for surgical complications after D2 gastrectomy following NAC are also unknown. The aim of the present study was to identify risk factors for postoperative complications after D2 surgery following NAC. Methods: This study was conducted as an exploratory analysis of a prospective randomized phase II trial of NAC. This randomized phase II trial compared two and four courses of neoadjuvant S-1/cisplatin (SC) and paclitaxel/cisplatin (PC) using a two-by-two factorial design for locally advanced gastric cancer. Sample size was set at 60 to 80 to achieve 10% improvement of 3-year OS by four courses or by PC with approximately 80% probability of the correct selection. The surgical complications were assessed and classified according to the Clavien-Dindo classification. The uni- and multivariate logistic regression analyses were performed to identify risk factors for morbidities. Results: Among the 83 patients who were registered in the phase II trial, 69 patients received NAC and D2 gastrectomy. Postoperative complications were identified in 18 patients, and the overall morbidity rate was 26.1%. The results of the univariate and multivariate analyses of various factors potentially affecting the overall surgical morbidity identified a creatinine clearance (CCr) < 60ml/min (P = 0.016) as the sole significant independent risk factor for overall morbidity. The incidence of pancreatic fistula was significantly higher in the patients with a low CCr than in those with a high CCr. Conclusions: A low CCr was found to be a significant risk factor for surgical complications associated with D2 gastrectomy after NAC. Careful attention is therefore required for these patients. Clinical trial information: UMIN000002595.

Risk factors associated with early postoperative complications following laparoscopic total gastrectomy: Experience from the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) group.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15544-e15544
Author(s):  
Jingdong Liu ◽  
Haojie Li ◽  
Gang Zhao ◽  
Zekuan Xu ◽  
Guoxin Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Postoperative Complications ◽  
Total Gastrectomy ◽  
Multivariable Analysis ◽  
Laparoscopic Total Gastrectomy ◽  
Morbidity And Mortality ◽  
Reconstruction Method ◽  
Factors Associated ◽  
Early Postoperative Complications

e15544 Background: The incidence rate of proximal gastric cancer has been rising steadily, and laparoscopic total gastrectomy (LTG) has been widely adopted. However, the safety of LTG still lacks solid evidence to prove. The aim of this study was to evaluate morbidity and mortality of LTG, and determine the risk factors associated with early postoperative complications. Methods: A retrospective multicenter study was carried out in China, and medical records of 109 gastric cancer patients receiving LTG during September 2014 and June 2016 were retrieved from the database. Patient characteristics, surgical outcomes, and postoperative morbidities and mortalities were analyzed. Results: Morbidity and mortality rates were 22.0% and 0% respectively. Pulmonary infection (13.8%, n = 15) was the most common complication. Most complications were grade II (15.5%, n = 17) according to the Clavien-Dindo classification. Multivariable analysis identified comorbidity, type of reconstruction method (TLTG) were independent risk factors of early postoperative complications. Comorbidity was the only independent risk factor of complications graded more than II. Diabetes mellitus was found correlated with surgical complication in subgroup analysis. Conclusions: LTG is safe and technically feasible in treating gastric cancer. Careful selection of patients without comorbidity and applying laparoscopy-assisted total gastrectomy instead of totally laparoscopic total gastrectomy may decrease postoperative complications.

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

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1890 ◽  
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.

scholarly journals MINIMALLY INVASIVE SURGERY FOR GASTRIC CANCER: TIME TO CHANGE THE PARADIGM

2016 ◽  
Vol 29 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Leandro Cardoso BARCHI ◽  
Carlos Eduardos JACOB ◽  
Cláudio José Caldas BRESCIANI ◽  
Osmar Kenji YAGI ◽  
Donato Roberto MUCERINO ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Large Scale ◽  
Laparoscopic Approach ◽  
Current Status ◽  
Cochrane Library ◽  
Robotic Gastrectomy ◽  
Conventional Surgery

ABSTRACT Introduction: Minimally invasive surgery widely used to treat benign disorders of the digestive system, has become the focus of intense study in recent years in the field of surgical oncology. Since then, the experience with this kind of approach has grown, aiming to provide the same oncological outcomes and survival to conventional surgery. Regarding gastric cancer, surgery is still considered the only curative treatment, considering the extent of resection and lymphadenectomy performed. Conventional surgery remains the main modality performed worldwide. Notwithstanding, the role of the minimally invasive access is yet to be clarified. Objective: To evaluate and summarize the current status of minimally invasive resection of gastric cancer. Methods: A literature review was performed using Medline/PubMed, Cochrane Library and SciELO with the following headings: gastric cancer, minimally invasive surgery, robotic gastrectomy, laparoscopic gastrectomy, stomach cancer. The language used for the research was English. Results: 28 articles were considered, including randomized controlled trials, meta-analyzes, prospective and retrospective cohort studies. Conclusion: Minimally invasive gastrectomy may be considered as a technical option in the treatment of early gastric cancer. As for advanced cancer, recent studies have demonstrated the safety and feasibility of the laparoscopic approach. Robotic gastrectomy will probably improve outcomes obtained with laparoscopy. However, high cost is still a barrier to its use on a large scale.

Risk factors for postoperative complications after gastrectomy in gastric cancer patients with comorbidities

Surgery Today ◽  
2015 ◽  
Vol 46 (2) ◽  
pp. 224-228 ◽  
Author(s):  
Takuya Hamakawa ◽  
Yukinori Kurokawa ◽  
Jota Mikami ◽  
Yasuhiro Miyazaki ◽  
Tsuyoshi Takahashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Gastric Cancer Patients

scholarly journals Impact of postoperative complications on long-term survival of gastric cancer patients: results from a high-volume institution in China

2020 ◽  
Author(s):  
Hua-Yang Pang ◽  
Hui Wang ◽  
Lin-Yong Zhao ◽  
Xiao-Long Chen ◽  
Kai Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Prognostic Factor ◽  
Postoperative Complications ◽  
Pulmonary Infection ◽  
Independent Prognostic Factor ◽  
Term Survival ◽  
Long Term Survival ◽  
Independent Risk Factors

Abstract BackgroundThis study was aimed to evaluate the impact of postoperative complications (POCs) on long-term survival for gastric cancer (GC) patients with curative resection.MethodsFrom January 2009 to December 2014, a total of 1667 GC patients with curative gastrectomy were analyzed. Patients with any complications Clavien–Dindo (CD) grade II or higher were divided into complication group. Independent risk factors for the development of POCs and the relationship between POCs and long-term survival (excluding death within 90 days after surgery) were analyzed.ResultsOverall POCs CD ≥ 2 were diagnosed in 285 (17.10%) patients including infectious complications (ICs) in 231 (13.9%) and noninfectious complications (NICs) in 78 (4.68%) patients. Age ≥ 65 (P = 0.003), presence of comorbidity (P = 0.019), extensive lymphadenectomy (P = 0.027) and perioperative blood transfusion (P = 0.040) were independent risk factors of POCs. Multivariate analysis identified that presence of POCs (P < 0.001) was an independent prognostic factor and further analysis by complication type demonstrated that the deteriorated overall survival was mainly caused by ICs (P = 0.007) rather than NICs (P = 0.075), moreover, among all complications, pulmonary infection (P < 0.001) was the only significant prognostic factor.ConclusionPOCs may be an independent prognostic factor for long-term survival of GC patients and the risk is mainly driven by ICs, particular pulmonary infection.

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