Risk factors for persistent elevation of perioperative lactate levels in gastric cancer surgery

2020 ◽  
Vol 11 (5) ◽  
pp. 24-28
Author(s):  
Selcuk Gulmez ◽  
Orhan Uzun ◽  
Aziz Serkan Senger ◽  
Zehra Zeynep Keklikkiran ◽  
Hilmi Bozkurt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Operative Time ◽  
Multivariate Logistic Regression Analysis ◽  
Perioperative Period ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Icu Stay ◽  
Lactate Levels ◽  
The Impact

Background: The impact of high-risk surgery on tissue perfusion can be indirectly assessed by measuring lactate levels during surgery and intensive care unit (ICU) stay. While consistently high values are associated with poor prognosis, transient elevations do not mean poor clinical outcomes. Therefore, intraoperative and early postoperative blood lactate monitoring is essential for cancer patients. Aims and Objective: This study aimed to determine the risk factors of persistently elevated lactate levels in the intraoperative and postoperative period in patients with elective gastric cancer surgery. Materials and Methods: We retrospectively enrolled 293 patients who underwent curative resection for gastric cancer. Lactate values of all patients were examined during surgery and ICU-stay at 3rd, 6th, 12th, and 18th hours. All lactate values above 2 mmol/L were considered elevated. The patients were divided into two groups as those with perioperative persistently increased lactate levels and those without. Results: Of the 293 patients, 60 (20.5%) had higher lactate levels in the perioperative period. According to multivariate logistic regression analysis, the operative time had the highest significance rate (p = 0.020) out of two significant variables, followed by the BMI ≥ 30 kg/m2 (p = 0.048). Besides, patients with perioperative hyperlactatemia had prolonged hospital stays (p = 0.034). Conclusions: Operative time and obesity (BMI ≥ 30 kg/m2) were independent risk factors for persistent lactate elevation in the perioperative period. Also, perioperative hyperlactatemia extended the length of hospital stay.

scholarly journals Risk Factors for Gallbladder Stone Formation after Gastric Cancer Surgery

2019 ◽  
Vol 19 (4) ◽  
pp. 417
Author(s):  
Young-Won Lee ◽  
Amy Kim ◽  
Minkyu Han ◽  
Moon-Won Yoo
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Stone Formation ◽  
Cancer Surgery ◽  
Gallbladder Stone ◽  
Gastric Cancer Surgery

scholarly journals The incidence and risk factors for surgical site infection in older adults after gastric cancer surgery

Medicine ◽  
2019 ◽  
Vol 98 (32) ◽  
pp. e16739
Author(s):  
Jung Ho Kim ◽  
Jinnam Kim ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
Heun Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Older Adults ◽  
Surgical Site Infection ◽  
Cancer Surgery ◽  
Site Infection ◽  
Gastric Cancer Surgery

Impact of preoperative sarcopenia on recurrecnce in gastric cancer surgery.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 120-120
Author(s):  
Tsutomu Sato ◽  
Toru Aoyama ◽  
Yukio Maezawa ◽  
Kazuki Kano ◽  
Kenki Segami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Risk Factor ◽  
Muscle Mass ◽  
Significant Risk ◽  
Cancer Surgery ◽  
Pathological Stage ◽  
Gastric Cancer Surgery ◽  
Negative Prognostic Factor

120 Background: Our previous study clarified that morbidity was a negative prognostic factor and sarcopenia defined by of the handgrip strength was a risk factor for the morbidity in gastric cancer surgery. Sarcopenia was reportedly a negative prognostic factor in colorectal cancer, hepatocellular carcinoma and malignant melanoma. This study aimed to evaluate impact of preoperative sarcopenia on recurrence-free survival (RFS) in gastric cancer surgery. Methods: Between May 2011 and June 2013, 256 consecutive primary gastric cancer patients who underwent curative surgery were retrospectively examined. Patients who received neoadjuvant chemotherapy or were diagnosed with pathological stage IV were excluded. Preoperative skeletal muscle mass was evaluated by bioelectrical impedance analysis and was expressed as skeletal muscle index or SMI (muscle mass/height2) by adjusting absolute muscle mass with height. Preoperative muscle function was measured by hand grip strength (HGS). Each cutoff value was determined as the gender-specific lowest 20% of the distribution of each measurement. Univariate and multivariate analyses were preformed to identify risk factors for RFS using a Cox proportional hazards model. Results: Median age (range) was 66 years (37-85 years). Male to female ratio was 168:88. Median follow-up period was 33.4 months. Pathological stage was I in 160, II in 48 and III in 48 patients. Univariate analysis showed that age, adjuvant chemotherapy, pT, pN, histological type, tumor size, total gastrectomy, low SMI and low HGS were significant risk factors for RFS. Multi-variate Cox’s proportional hazard analyses demonstrated that pT (HR 2.76, p = 0.0001), pN (HR 1.375, p = 0.037), histological type (HR 3.46, p = 0.014), low SMI (HR2.17, p = 0.036) were the significant risk factors for RFS. The three-year RFS was 89.1% in the patients with high SMI and 73.2% in those with low SMI (p = 0.007). Conclusions: Low SMI was an independent risk factor for RFS in Stage I-III gastric cancer. Low HGS, a risk factor for morbidity shown in our previous study, was not a risk independent factor for RFS. Preoperative sarcopenia as the short- and long-term outcomes has a value to be tested in the future prospective studies in gastric cancer surgery.

scholarly journals The Impact of COVID-19 on Gastric Cancer Surgery: A Single-center Retrospective Study Based on Real-world Data from China

2020 ◽  
Author(s):  
Yu-xuan Li ◽  
Chang-zheng He ◽  
Yi-chen Liu ◽  
Peng-yue Zhao ◽  
Xiao-lei Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Waiting Times ◽  
Cancer Surgery ◽  
Real World Data ◽  
Gastric Cancer Surgery ◽  
Patients With Cancer ◽  
Study Results ◽  
Gastric Cancer Patients ◽  
The Impact

Abstract Backgrounds: A respiratory epidemic defined as coronavirus disease 2019 (COVID-19) is becoming unstoppable and has been declared a pandemic. Patients with cancer are more likely to develop COVID-19. Based on our experience during the pandemic period, we propose some surgery strategies for gastric cancer patients under the COVID-19 situation. Methods We defined the ‘COVID-19’ period as occurring between 2020-01-20 and 2020-03-20. All the enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. Results The waiting times before admission increased by 4 days in CG(PCG:4.5 [IQR: 2, 7.8] vs. CG:8.0 [IQR: 2,20]; P = 0.006). More patients had performed chest CT scan besides abdominal CT before admission during COVID-19 period(PCG:22[32%]vs. CG:30[73%], p = 0.001). After admission, during COVID period, the waiting time before surgery was longer(3[IQR: 2,5] vs. 7[IQR: 5,9]; P < 0.001),more laparoscopic surgery were performed(PCG: 51[75%] vs. CG: 38[92%],p = 0.021), and hospital stay after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11] ; P < 0.001). The total cost of hospitalization increased during COVID period, (9.22[IQR:7.82,10.97] vs. 10.42[IQR:8.99,12.57]; p = 0.006). Conclusion Since no data is available yet on the impact of COVID-19 on gastric cancer patients,our own experience with COVID-19 in gastric cancer surgery has hopefully provided an opportunity for colleagues to reflect on their own service and any contingency plans they have to tackle the crisis.

Postoperative mortality after esophageal and gastric cancer surgery: Does age still matter? Results from a nationwide study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 122-122
Author(s):  
Christophe Mariette ◽  
Arnaud Pasquer ◽  
Florence Renaud ◽  
Flora Hec ◽  
Anne Gandon ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Age Groups ◽  
Postoperative Mortality ◽  
Linear Increase ◽  
Cancer Surgery ◽  
Charlson Score ◽  
Cumulative Impact ◽  
Study Objective ◽  
Gastric Cancer Surgery ◽  
The Impact

122 Background: More than age, patient comorbidity is increasingly considered as the prominent predictor of postoperative mortality (POM) in esophageal and gastric cancer surgery, leading a growing number of elderly to be operated on. However, the respective impact of age and comorbidity on POM remains to be elucidated. The study objective was to investigate the impact of age on POM according to patient comorbidity. Methods: All consecutive patients who underwent esophageal or gastric cancer surgery between 2010 and 2012 in France were included (n = 11,196). The 30-day POM was compared by age groups (20-39, 40-59, 60-79, ≥ 80) and stratified according to the Charlson score (0, 1-2, ≥ 3). The consistency across esophageal (n = 3286) and gastric (n = 7910) subgroups and variations between 30-day and 90-day POM were analyzed. Results: Patients ≥ 60 years represented 73.8% of cases. A linear increase in 30-day and 90-day POM was observed with increasing age, with rates of 0.9% and 2.1%, 2.4% and 5.4%, 4.8% and 8.8%, and 9.3% and 15.9% in 20-39, 40-59, 60-79, ≥ 80 years age groups, respectively ( P< 0.001). Comparing 20-39 and ≥ 80 years age groups, 30-day POM was 1.0% vs. 7.0% for Charlson 0 ( P< 0.001), 3.1% vs. 11.1% for Charlson1-2 ( P< 0.001) and 0% vs. 19.5% for Charlson ≥ 3 ( P= 0.020) patients. A similar linear increase of POM by growing age groups was observed for 90-day POM and in esophagus and stomach subgroups. By multivariable analysis age groups (OR 1.03 95%CI 1.02-1.04, p < 0.001) and Charlson score (OR 1.56 95%CI 1.43-1.70, p < 0.001) were independent predictors of POM. Conclusions: Age and patient comorbidity have a similar and cumulative impact on POM after esophageal and gastric cancer surgery.

scholarly journals The effect on glycemic status in type 2 diabetes mellitus after gastric cancer surgery

2020 ◽  
Vol 8 (1) ◽  
pp. 191
Author(s):  
Lakshmi Radhakrishnan ◽  
T. V. Haridas
Keyword(s):  
Gastric Cancer ◽  
Metabolic Surgery ◽  
Cancer Surgery ◽  
P Value ◽  
Glycemic Status ◽  
Chi Square ◽  
Gastric Cancer Surgery ◽  
Type 2 Dm ◽  
The Impact

Background: Gastric cancer is a leading cause of cancer death worldwide. With progress in the field of gastric cancer treatment, as indicated by the improved survival rate, postoperative quality of life as well as the appropriate surgical treatment for a cure has become very important. Recently, metabolic surgery has become an appealing treatment option for patients with type 2 DM. Although the purpose of metabolic surgery and gastric cancer surgery is completely different, they are related clinically and technically. Thus organized evaluation of the impact of gastric cancer surgery on diabetes is necessary.Methods: 30 patients with gastric cancer and type 2 DM who underwent curative gastrectomy were selected. Patients were followed up till 12 months, the study population grouped depending upon the glycemic status and results compared using chi square test.Results: Three out of 30 patients had complete remission of diabetes at 12 months, 17 patients improved and 10 patients remained stationary. Short duration (<5 years) had a median reduction in insulin by 8.9 units versus 2.5 units in long duration (>10 years) diabetes. Maximum reduction (>10 U/day) and remission occurred in those who underwent total gastrectomy. The results were compared using chi square test and the p value was 0.048428 (<0.05) proving significant.Conclusions: The glycemic status was found to improve following gastric cancer surgery which was found to be related to the extent of gastrectomy and the diabetes duration and was found to be statistically significant.

scholarly journals The Incidence and Risk Factors for Metachronous Gastric Cancer in the Remnant Stomach after Gastric Cancer Surgery

Gut and Liver ◽  
2021 ◽  
Author(s):  
Yonghoon Choi ◽  
Nayoung Kim ◽  
Hyuk Yoon ◽  
Cheol Min Shin ◽  
Young Soo Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Remnant Stomach ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Metachronous Gastric Cancer
Sign in / Sign up

Export Citation Format

Share Document