Clavien-Dindo classification of complications after minimally invasive surgery for gastric cancer and the influential factors
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R735.2

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    Abstract:

    Objective: To investigate the grades of Clavien-Dindo classification of complications after minimally invasive surgery for gastric cancer and the influential factors. Methods: The clinical data of 332 patients undergoing laparoscopy gastrectomy from January 2006 to March 2016 were retrospectively analyzed. The postoperative complications were assessed by Clavien-Dindo classification, and the influential factors for postoperative complications were analyzed. Results: In the 332 patients, postoperative complications occurred in 48 cases (14.5%), of whom, the Clavien-Dindo classification of complications was classified as grade I in 1 case (2.1%), grade II in 36 cases (75.0%), grade IIIa in 3 cases (6.3%), grade IIIb in 7 cases (14.6%) and grade IVa in 1 case (2.1%). The complications included anastomotic fistula in 19 cases (39.6%), intestinal obstruction in 6 cases (12.5%), intraperitoneal infection in 6 cases (12.5%), anastomotic hemorrhage in 5 cases (10.4%), intraperitoneal hemorrhage in 4 cases (8.3%), delayed gastric emptying in 4 cases (8.3%), duodenal stump fistula in 3 cases (6.3%), anastomotic stenosis in 3 cases (6.3%), lymphatic fistula in 2 cases (4.2%) and wound infection in 1 case (2.1%); some patients had multiple complications. Results of multivariate logistic regression analysis showed that BMI equal to or greater than 24.0 kg/m2, concomitant underlying diseases, Billroth II anastomosis and Roux-en-Y gastro- or esophago-jejunostomy were independent risk factors for postoperative complications (all P<0.05); the grades of Clavien-Dindo classification were significantly different between patients with different BMI, with or without underlying diseases and with different anastomosis methods (all P<0.05). Conclusion: In patients undergoing laparoscopy gastrectomy, the majority of postoperative complications belong to grade II of Clavien-Dindo classification and anastomotic fistula is the most common one. BMI, concomitant underlying diseases and anastomosis methods are independent factors for postoperative complications.

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SU Xiaowen, DENG Jianzhong, LIANG Weicheng. Clavien-Dindo classification of complications after minimally invasive surgery for gastric cancer and the influential factors[J]. Chin J Gen Surg,2017,26(10):1297-1303.
DOI:10.3978/j. issn.1005-6947.2017.10.012

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History
  • Received:March 21,2017
  • Revised:August 25,2017
  • Adopted:
  • Online: October 15,2017
  • Published: