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©2010 Baishideng.
World J Gastroenterol. Jan 7, 2010; 16(1): 98-103
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.98
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.98
Table 1 Demographic data of the patients
Items | Percentage (%) |
Age group (yr) | |
≤ 60 | 54.1 |
61-70 | 25.2 |
≥ 71 | 20.7 |
Sex | |
Male | 68.9 |
Female | 31.1 |
Diagnosis | |
Primary gastric cancer | 97.4 |
Gastric stump cancer1 | 2.6 |
Site of tumor | |
Proximal | 17.6 |
Body | 13.5 |
Distal | 43.3 |
Large or multiple | 25.6 |
No. of procedures | |
Partial gastrectomy | 76.0 |
Total gastrectomy | 24.0 |
Type of resection | |
Radical gastrectomy | 91.6 |
Palliative gastrectomy | 8.4 |
Combined resection | |
Yes | 4.4 |
No | 95.6 |
Type of anastomosis | |
Billroth I | 47.6 |
Billroth II | 13.9 |
Billroth reverse2 | 13.4 |
Roux-en-Y | 21.6 |
Roux-en-Y (P-shape) | 3.0 |
Others | 0.5 |
Unknown | 0.3 |
TNM stage | |
IA | 12.1 |
IB | 8.5 |
II | 18.1 |
IIIA | 20.8 |
IIIB | 16.2 |
IV | 24.3 |
Table 2 Details of complications
Complications | Frequency | Percentage (%) |
Hemorrhage | ||
Wound | 1 | 0.1 |
Deep | 16 | 1.0 |
Wound dehiscence | ||
Superficial | 9 | 0.5 |
Deep | 5 | 0.3 |
Anastomotic leak | 38 | 2.3 |
Infection | ||
Wound | 15 | 0.9 |
Deep | 80 | 4.9 |
Pyrexia of unknown origin | 253 | 15.4 |
Septicemia | 7 | 0.4 |
Chest | 172 | 10.5 |
Urinary tract infection | 20 | 1.2 |
System failure | ||
Renal | 28 | 1.7 |
Respiratory | 22 | 1.3 |
Cardiac | 13 | 0.8 |
Hypotension | 16 | 1.0 |
Deep venous thrombosis | 4 | 0.2 |
Death | 17 | 1.0 |
Overall | 506 | 30.9 |
Table 3 Innominate complications
Complications | Frequency | Percentage (%) |
Pleural effusion | 213 | 13 |
Continuous or relapsing pyrexia of unknown origin | 170 | 10.4 |
Seroperitoneum | 118 | 7.2 |
Gastro or enteroplegia, anastomosis edema, ileus | 75 | 4.6 |
Suspicious or sub-clinical anastomotic leak | 57 | 3.5 |
Pancreatitis | 22 | 1.3 |
Central vein catheter infection | 14 | 0.9 |
Anastomosis site or upper GI bleeding | 10 | 0.6 |
Chyle leak | 8 | 0.5 |
Pancreatic fistula | 6 | 0.4 |
Table 4 Difference of complication rate between partial and total gastrectomy
LN dissection | Radical | Palliative | ||||
Gastrectomy | Partial | Total | Sig | Partial | Total | Sig |
Overall | 308 (26.7) | 142 (40.9) | < 0.001 | 32 (34.8) | 24 (52.2) | NS |
Reoperation | 23 (2.0) | 12 (3.5) | NS | 1 (1.1) | 0 | NS |
Hemorrhage | ||||||
Wound | 1 (0.1) | 0 | NS | 0 | 0 | |
Deep | 11 (1.0) | 4 (1.2) | NS | 1 (1.1) | 0 | NS |
Wound dehiscence | ||||||
Superficial | 7 (0.6) | 1 (0.3) | NS | 1 (1.1) | 0 | NS |
Deep | 4 (0.3) | 1 (0.3) | NS | 0 | 0 | |
Leak | 22 (1.9) | 12 (3.5) | NS | 1 (1.1) | 3 (6.5) | NS |
Infection | ||||||
Wound | 8 (0.7) | 6 (1.7) | NS | 1 (1.1) | 0 | NS |
Deep | 42 (3.6) | 30 (8.6) | < 0.001 | 5 (5.4) | 3 (6.5) | NS |
PUO | 165 (14.3) | 65 (18.7) | 0.044 | 13 (14.1) | 10 (21.7) | NS |
Septicemia | 1 (0.1) | 6 (1.7) | < 0.001 | 0 | 0 | |
Chest | 86 (7.5) | 61 (17.6) | < 0.001 | 14 (15.2) | 11 (23.9) | NS |
UTI | 13 (1.1) | 6 (1.7) | NS | 1 (1.1) | 0 | NS |
System failure | ||||||
Renal | 15 (1.3) | 12 (3.5) | 0.008 | 1 (1.1) | 0 | NS |
Respiratory | 12 (1.0) | 7 (2.0) | NS | 3 (3.3) | 0 | NS |
Cardiac | 5 (0.4) | 6 (1.7) | 0.034 | 2 (2.2) | 0 | NS |
Hypotension | 8 (0.7) | 6 (1.7) | NS | 2 (2.2) | 0 | NS |
DVT | 1 (0.1) | 3 (0.9) | NS | 1 (1.1) | 0 | NS |
Death | 6 (0.5) | 8 (2.3) | 0.007 | 2 (2.2) | 1 (2.2) | NS |
Table 5 Difference of complications rate between radical and palliative LN dissection
LN dissection | Partial | Total | ||||
Gastrectomy | Radical | Palliative | Sig | Radical | Palliative | Sig |
Overall | 308 (26.7) | 32 (34.8) | NS | 142 (40.9) | 24 (52.2) | NS |
Reoperation | 23 (2.0) | 1 (1.1) | NS | 12 (3.5) | 0 | NS |
Hemorrhage | ||||||
Wound | 1 (0.1) | 0 | NS | 0 | 0 | NS |
Deep | 11 (1.0) | 1 (1.1) | NS | 4 (1.2) | 0 | NS |
Wound dehiscence | ||||||
Superficial | 7 (0.6) | 1 (1.1) | NS | 1 (0.3) | 0 | NS |
Deep | 4 (0.3) | 0 | NS | 1 (0.3) | 0 | NS |
Leak | 22 (1.9) | 1 (1.1) | NS | 12 (3.5) | 3 (6.5) | NS |
Infection | ||||||
Wound | 8 (0.7) | 1 (1.1) | NS | 6 (1.7) | 0 | NS |
Deep | 42 (3.6) | 5 (5.4) | NS | 30 (8.6) | 3 (6.5) | NS |
PUO | 165 (14.3) | 13 (14.1) | NS | 65 (18.7) | 10 (21.7) | NS |
Septicemia | 1 (0.1) | 0 | NS | 6 (1.7) | 0 | NS |
Chest | 86 (7.5) | 14 (15.2) | 0.008 | 61 (17.6) | 11 (23.9) | NS |
UTI | 13 (1.1) | 1 (1.1) | NS | 6 (1.7) | 0 | NS |
System failure | ||||||
Renal | 15 (1.3) | 1 (1.1) | NS | 12 (3.5) | 0 | NS |
Respiratory | 12 (1.0) | 3 (3.3) | NS | 7 (2.0) | 0 | NS |
Cardiac | 5 (0.4) | 2 (2.2) | NS | 6 (1.7) | 0 | NS |
Hypotension | 8 (0.7) | 2 (2.2) | NS | 6 (1.7) | NS | |
DVT | 1 (0.1) | 1 (1.1) | NS | 3 (0.9) | 0 | NS |
Death | 6 (0.5) | 2 (2.2) | NS | 8 (2.3) | 1 (2.2) | NS |
Table 6 Causes of reoperation
Causes | Surgical management | Frequency |
Intra-abdominal hemorrhage1 | Simple hemostasis | 16 |
Anastomotic leak | Repair and placement of drainage | 10 |
Deep wound dehiscence | Closure of abdominal wall | 4 |
Abdominal infection | Debridement and placement of drainage | 3 |
Ileus | Adhesiolysis of small intestine | 2 |
Anastomotic obstruction | Reconstruction | 1 |
Table 7 Potential causes of death
Complications | Reoperation n (%) | |
Yes (n = 36) | No (n = 1603) | |
Death | 4 (11.11) | 13 (0.81) |
Extent of surgery | ||
LN dissection | ||
Radical | 4 (11.11) | 10 (0.62) |
Palliative | 0 | 3 (0.18) |
Gastrectomy | ||
Partial | 1 (0.03) | 7 (0.44) |
Total | 3 (8.33) | 6 (0.37) |
Complications | ||
Intra abdominal hemorrhage | 1 (0.03) | 0 |
Anastomotic leak | 2 (5.55) | 0 |
Infection | ||
Deep | 1 (0.03) | 2 (0.12) |
Pyrexia of unknown origin | 0 | 3 (0.18) |
Septicemia | 0 | 1 (0.06) |
Chest | 3 (8.33) | 7 (0.44) |
Urinary tract | 2 (5.55) | 0 |
System failure | ||
Renal | 3 (8.33) | 8 (0.49) |
Respiratory | 4 (11.11) | 10 (0.62) |
Cardiac | 2 (5.55) | 9 (0.56) |
Hypotension | 1 (0.03) | 9 (0.56) |
Deep venous thrombosis | 0 | 3 (0.18) |
Pancreatitis | 0 | 1 (0.06) |
Anastomosis site bleeding | 0 | 1 (0.06) |
- Citation: Sah BK, Chen MM, Yan M, Zhu ZG. Reoperation for early postoperative complications after gastric cancer surgery in a Chinese hospital. World J Gastroenterol 2010; 16(1): 98-103
- URL: https://www.wjgnet.com/1007-9327/full/v16/i1/98.htm
- DOI: https://dx.doi.org/10.3748/wjg.v16.i1.98