Postoperative Complications and Their Risk Factors of Completion Total Gastrectomy for Remnant Gastric Cancer Following an Initial Gastrectomy for Cancer

Park Sin Hye; Eom Sang Soo; Eom Bang Wool; Yoon Hong Man; Kim Young-Woo; Ryu Keun Won

doi:10.5230/jgc.2022.22.e19

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자료유형: 학술저널

저자정보: Park Sin Hye (Center for Gastric Cancer National Cancer Center Goyang Korea.) Eom Sang Soo (Center for Gastric Cancer National Cancer Center Goyang Korea.) Eom Bang Wool (Center for Gastric Cancer National Cancer Center Goyang Korea.) Yoon Hong Man (Center for Gastric Cancer National Cancer Center Goyang Korea.) Kim Young-Woo (Center for Gastric Cancer National Cancer Center Goyang Korea.Department of Cancer Control and Popu) Ryu Keun Won (Center for Gastric Cancer National Cancer Center Goyang Korea.)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제22권 제3호

발행연도: 2022.7

수록면: 210 - 219 (10page)

DOI: 10.5230/jgc.2022.22.e19

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Purpose Completion total gastrectomy (CTG) for remnant gastric cancer (RGC) is a technically demanding procedure and associated with increased morbidity. The present study aimed to evaluate postoperative complications and their risk factors following surgery for RGC after initial partial gastrectomy due to gastric cancer excluding peptic ulcer. Materials and Methods We retrospectively reviewed the data of 107 patients who had previously undergone an initial gastric cancer surgery and subsequently underwent CTG for RGC between March 2002 and December 2020. The postoperative complications were graded using the Clavien-Dindo classification. Logistic regression analyses were used to determine the risk factors for complications. Results Postoperative complications occurred in 34.6% (37/107) of the patients. Intra-abdominal abscess was the most common complication. The significant risk factors for overall complications were multi-visceral resections, longer operation time, and high estimated blood loss in the univariate analysis. The independent risk factors were multi-visceral resection (odds ratio [OR], 2.832; 95% confidence interval [CI], 1.094?7.333; P=0.032) and longer operation time (OR, 1.005; 95% CI, 1.001?1.011; P=0.036) in the multivariate analysis. Previous reconstruction type, minimally invasive approach, and current stage were not associated with the overall complications. Conclusions Multi-visceral resection and long operation time were significant risk factors for the occurrence of complications following CTG rather than the RGC stage or surgical approach. When multi-visceral resection is required, a more meticulous surgical procedure is warranted to improve the postoperative complications during CTG for RGC after an initial gastric cancer surgery.

#Morbidity #Stomach neoplasm #Gastrectomy #Gastric stump

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