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RISK FACTORS FOR SEVERE POSTOPERATIVE COMPLICATIONS AFTER GASTRECTOMY FOR GASTRIC AND ESOPHAGOGASTRIC JUNCTION CANCERS
- Source :
- Arquivos Brasileiros de Cirurgia Digestiva : ABCD, ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.32 n.4 2019, ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), Colégio Brasileiro de Cirurgia Digestiva (CBCD), instacron:CBCD, ABCD: Arquivos Brasileiros de Cirurgia Digestiva
- Publication Year :
- 2019
-
Abstract
- Background: Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. Total morbidity rates vary across different studies and few have evaluated postoperative morbidity according to complication severity. Aim: To identify the predictors of severe postoperative morbidity. Methods: This was a retrospective cohort study from a prospective database. We included patients treated with gastrectomy for gastric or EGJ cancers between January 2012 and December 2016 at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3. A multivariate analysis was performed to identify predictors of severe morbidity. Results: Two hundred and eighty-nine gastrectomies were performed (67% males, median age: 65 years). Tumor location was EGJ in 14%, upper third of the stomach in 30%, middle third in 26%, and lower third in 28%. In 196 (67%), a total gastrectomy was performed with a D2 lymph node dissection in 85%. Two hundred and eleven patients (79%) underwent an open gastrectomy. T status was T1 in 23% and T3/T4 in 68%. Postoperative mortality was 2.4% and morbidity rate was 41%. Severe morbidity was 11% and was mainly represented by esophagojejunostomy leak (2.4%), duodenal stump leak (2.1%), and respiratory complications (2%). On multivariate analysis, EGJ location and T3/T4 tumors were associated with a higher rate of severe postoperative morbidity. Conclusion: Severe postoperative morbidity after gastrectomy was 11%. Esophagogastric junction tumor location and T3/T4 status are risk factors for severe postoperative morbidity.
- Subjects :
- Male
medicine.medical_specialty
Neoplasias gástricas
RD1-811
Esophageal Neoplasms
medicine.medical_treatment
Stomach neoplasms
RC799-869
Adenocarcinoma
Single Center
Cohort Studies
Postoperative Complications
Gastrectomy
Risk Factors
medicine
Humans
Aged
Retrospective Studies
Gastrectomia
Fatores de risco
business.industry
Stomach
Mortality rate
Retrospective cohort study
General Medicine
Diseases of the digestive system. Gastroenterology
Middle Aged
Surgery
Morbidade
Dissection
medicine.anatomical_structure
Gastrectomy, Risk factors
Female
Original Article
Esophagogastric Junction
Morbidity
Complication
business
Cohort study
Subjects
Details
- ISSN :
- 23176326
- Volume :
- 32
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
- Accession number :
- edsair.doi.dedup.....de6aef6cbbf751219eea90b7f167ac1a