Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
BJS Open. 2023 Sep 5;7(5). doi: 10.1093/bjsopen/zrad101.
The incidence of postoperative complications after gastrectomy for gastric cancer is not well known. More population-based studies using established complication classifications are needed for international comparison. The aim of this study was to evaluate the population-based incidence of postoperative complications after gastrectomy for gastric cancer.
This population-based study based on the Finnish National Esophago-Gastric Cancer Cohort included all patients at least 18 years of age undergoing gastrectomy for gastric adenocarcinoma in Finland during 2005-2016. The occurrence of complications 30 and 90 days after surgery was graded based on the Esophagectomy Complications Consensus Group definitions and the severity of complications was assessed using the Clavien-Dindo scale.
This study included a total of 2196 patients. Postoperative complications occurred in 906 (41.3 per cent) of patients during 30 days after surgery and in 946 (43.1 per cent) during 90 days after surgery. Clavien-Dindo grade III or higher complications occurred in 375 (17.1 per cent) of patients. The most common complications 90 days after surgery by Esophagectomy Complications Consensus Group upper-level categories were gastrointestinal (n = 438; 19.9 per cent), including anastomotic leak, infectious (n = 377; 17.2 per cent) and pulmonary (n = 335; 15.3 per cent) complications. Postoperative mortality rate was occurred in 72 (3.3 per cent) patients within 30 days and in 161 (7.3 per cent) patients within 90 days after surgery. The median duration of postoperative hospital stay was 9 days (interquartile range 4-14).
Postoperative complications are common across all types of gastrectomy and the majority occur during the first 30 postoperative days. This study informs the patients and caregivers of the expected outcomes of gastrectomy.
胃癌胃切除术后并发症的发生率尚不清楚。需要更多使用既定并发症分类的基于人群的研究进行国际比较。本研究旨在评估胃癌胃切除术后基于人群的术后并发症发生率。
这项基于人群的研究基于芬兰国家食管胃腺癌队列，包括 2005 年至 2016 年期间在芬兰接受胃腺癌胃切除术的至少 18 岁的所有患者。术后 30 天和 90 天发生并发症的情况根据食管癌并发症共识小组的定义进行分级，并发症的严重程度使用 Clavien-Dindo 分级进行评估。
本研究共纳入 2196 例患者。术后 30 天内有 906 例（41.3%）患者发生术后并发症，90 天内有 946 例（43.1%）患者发生术后并发症。375 例（17.1%）患者发生 Clavien-Dindo 分级 III 级或更高的并发症。术后 90 天，按食管癌并发症共识小组上级别分类，最常见的并发症为胃肠道（n=438；19.9%），包括吻合口漏、感染（n=377；17.2%）和肺部（n=335；15.3%）并发症。术后 30 天内死亡率为 72 例（3.3%），90 天内死亡率为 161 例（7.3%）。术后住院时间中位数为 9 天（四分位间距 4-14）。
所有类型的胃切除术都有术后并发症，大多数发生在术后 30 天内。本研究为胃切除术患者及其家属提供了预期的结果。
