Pancreatic Fistula after D1+/D2 Radical Gastrectomy according to the Updated International Study Group of Pancreatic Surgery Criteria: Risk Factors and Clinical Consequences. Experience of Surgeons with High Caseloads in a Single Surgical Center in Eastern Europe

Catalin Vasilescu; Traian Dumitrascu; Mihnea Ionescu; Stefan Tudor; Monica Lacatus; Vlad Herlea; Alexandru Martiniuc

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저자정보: Catalin Vasilescu (Department of General Surgery Fundeni Clinical Institute Bucharest Romania) Traian Dumitrascu (Department of General Surgery Fundeni Clinical Institute Bucharest Romania) Mihnea Ionescu (Department of General Surgery Fundeni Clinical Institute Bucharest Romania) Stefan Tudor (Department of General Surgery Fundeni Clinical Institute Bucharest Romania) Monica Lacatus (Department of General Surgery Fundeni Clinical Institute Bucharest Romania) Vlad Herlea (Department of Pathology Fundeni Clinical Institute Bucharest Romania) Alexandru Martiniuc (Department of General Surgery Fundeni Clinical Institute Bucharest Romania)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제21권 제1호

발행연도: 2021.1

수록면: 16 - 29 (14page)

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Purpose: Incidence, risk factors, and clinical consequences of pancreatic fistula (POPF) after D1+/D2 radical gastrectomy have not been well investigated in Western patients, particularly those from Eastern Europe. Materials and Methods: A total of 358 D1+/D2 radical gastrectomies were performed by surgeons with high caseloads in a single surgical center from 2002 to 2017. A retrospective analysis of data that were prospectively gathered in an electronic database was performed. POPF was defined and graded according to the International Study Group for Pancreatic Surgery (ISGPS) criteria. Uni- and multivariate analyses were performed to identify potential predictors of POPF. Additionally, the impact of POPF on early complications and long-term outcomes were investigated. Results: POPF was observed in 20 patients (5.6%), according to the updated ISGPS grading system. Cardiovascular comorbidities emerged as the single independent predictor of POPF formation (risk ratio, 3.051; 95% confidence interval, 1.161?8.019; P=0.024). POPF occurrence was associated with statistically significant increased rates of postoperative hemorrhage requiring re-laparotomy (P=0.029), anastomotic leak (P=0.002), 90-day mortality (P=0.036), and prolonged hospital stay (P<0.001). The long-term survival of patients with gastric adenocarcinoma was not affected by POPF (P=0.661). Conclusions: In this large series of Eastern European patients, the clinically relevant rate of POPF after D1+/D2 radical gastrectomy was low. The presence of co-existing cardiovascular disease favored the occurrence of POPF and was associated with an increased risk of postoperative bleeding, anastomotic leak, 90-day mortality, and prolonged hospital stay. POPF was not found to affect the long-term survival of patients with gastric adenocarcinoma.

#Radical gastrectomy #Gastric cancer #Pancreatic fistula #Complications #Survival

참고문헌 (69)

참고문헌 신청

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