Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
3rd Division of General Surgery, Spedali Civili di Brescia, P.le Spedali Civili 1, 25127, Brescia, Italy.
Gastric Cancer. 2019 Jan;22(1):172-189. doi: 10.1007/s10120-018-0839-5. Epub 2018 May 30.
Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus.
The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications.
A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet.
The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.
围手术期并发症会影响胃癌手术后的结果,死亡率和发病率高达 10%至 40%。由于缺乏记录并发症的标准化系统,因此在评估其对结果的影响以及提出质量改进项目方面存在很大差异。本研究旨在提供一套经过国际共识认可的明确胃癌手术并发症分类。
胃癌并发症共识小组由 34 位欧洲胃癌专家组成,他们均为国际胃癌协会的成员。通过德尔菲调查,小组会议为实施研究制定了工作计划。就定义胃癌手术并发症的一套标准化方法达成共识。
创建了一套标准化的 27 种定义明确的并发症(分为 3 种术中并发症、14 种术后一般并发症和 10 种术后手术并发症),为记录单个胃癌手术并发症提供了一个简单但准确的模板。专家组还就胃癌手术后应视为主要不良事件的并发症清单及其具体定义达成共识。该研究小组还一致认为,应在患者出院时和术后 90 天使用并发症记录表对每个手术病例进行评估。
即将在国际多中心研究中验证的明确并发症清单以及正在开发的电子数据表应用程序,为实现标准化国际数据收集、建立基准结果以及促进质量改进项目的最终目标提供了基本的基础设施。