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Risk factors of postoperative complications and their effect on survival after laparoscopic gastrectomy for gastric cancer

Authors :
Vo Duy Long
Dang Quang Thong
Tran Quang Dat
Doan Thuy Nguyen
Nguyen Viet Hai
Ho Le Minh Quoc
Nguyen Vu Tuan Anh
Nguyen Lam Vuong
Nguyen Hoang Bac
Source :
Annals of Gastroenterological Surgery, Vol 8, Iss 4, Pp 580-594 (2024)
Publication Year :
2024
Publisher :
Wiley, 2024.

Abstract

Abstract Background The association between postoperative complications and long‐term survival after laparoscopic gastrectomy (LG) for gastric cancer (GC) remains uncertain. This study aimed to determine the incidence and risk factors of postoperative complications and evaluate their impact on survival outcomes in patients undergoing LG. Methods A retrospective study was conducted on 621 patients who underwent LG for gastric adenocarcinoma between March 2015 and December 2021. Postoperative complications were classified according to the Clavien–Dindo classification, with major complications defined as Grade III or higher. Logistic regression models with stepwise backward procedure were used to identify risk factors for complications. To assess the impact of postoperative complications on survival, uni‐ and multi‐variable Cox proportional hazard models were used for overall survival (OS) and disease‐free survival (DFS). Results Overall rate of postoperative complications was 17.6% (109 patients); 33 patients (5.3%) had major complications. Independent risk factors for major complications were Charlson comorbidities index (OR [95% CI], 1.87 [1.09–3.12], p‐value = 0.018 for each one score increase), and type of anastomosis (OR [95% CI], 0.28 [0.09–0.91], p‐value = 0.029 when comparing Billroth II with Billroth I). Multivariable analysis identified major complications as an independent prognostic factor to reduce OS (HR [95% CI], 2.32 [1.02–5.30], p‐value = 0.045) and DFS (HR [95% CI], 2.63 [1.37–5.06], p‐value = 0.004). Other prognostic factors for decreased survival outcomes were tumor size, presence of invasive lymph nodes, and T4a stage. Conclusions Major complications rate of LG for GC was approximately 5.3%. Charlson comorbidities index and type of anastomosis were identified as risk factors for major postoperative complications. Major complications were demonstrated to pose adverse impact on survival outcomes.

Details

Language :
English
ISSN :
24750328
Volume :
8
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Annals of Gastroenterological Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.5ecd0ffd58649779803e04f821926c2
Document Type :
article
Full Text :
https://doi.org/10.1002/ags3.12780