Putila Emilia, Helminen Olli, Helmiö Mika, Huhta Heikki, Jalkanen Aapo, Junttila Anna, Kallio Raija, Koivukangas Vesa, Kokkola Arto, Lietzen Elina, Louhimo Johanna, Meriläinen Sanna, Pohjanen Vesa-Matti, Rantanen Tuomo, Ristimäki Ari, Räsänen Jari V, Saarnio Juha, Sihvo Eero, Toikkanen Vesa, Tyrväinen Tuula, Valtola Antti, Kauppila Joonas H
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.
Ann Surg Oncol. 2025 Jun 23. doi: 10.1245/s10434-025-17674-2.
Previously, no international consensus on reporting complications after gastric cancer surgery existed, making comparisons between studies difficult. In 2015 the Esophagectomy Complications Consensus Group (ECCG) published a standardized list for classification of postoperative complications after esophagectomy for esophageal cancer, which also was applied for gastric cancer. In 2019 the Gastrectomy Complications Consensus Group (GCCG) reported outcomes after gastrectomy for gastric cancer with a list of different complication types. This study aimed to compare the two classifications in reporting postoperative outcomes after gastrectomy for gastric cancer.
This population-based study, based on the Finnish National Esophago-Gastric Cancer Cohort, included all patients age 18 years or older undergoing gastrectomy for gastric cancer in Finland during 2010-2016. For classifying and describing different postoperative outcomes, both the ECCG and GCCG lists of complications were used separately.
The study analyzed 1115 patients. The occurrence of complications 90 days postoperatively was 23.0% according to the GCCG classification (504 individual complications) and 43.0% according to the ECCG classification (1084 individual complications). Most of the notable differences between the classifications in reporting complications were in cardiac dysrhythmia, infections, and myocardial infarction, with the GCCG classification reporting a lower incidence. Additionally, 131 complications occurring in 13 individual types of complications defined only in the ECCG and not in the GCCG were recorded.
This study suggests that the ECCG classification is more comprehensive and sensitive in evaluating complications of gastrectomy than the GCCG classification. Use of the ECCG classification may be preferable in the context of gastrectomy.
此前，对于胃癌手术后并发症的报告尚无国际共识，这使得不同研究之间难以进行比较。2015年，食管癌切除术后并发症共识小组（ECCG）发布了一份标准化清单，用于对食管癌切除术后的术后并发症进行分类，该清单也适用于胃癌。2019年，胃切除术并发症共识小组（GCCG）报告了胃癌胃切除术后的结果，并列出了不同的并发症类型。本研究旨在比较这两种分类方法在报告胃癌胃切除术后的术后结果方面的差异。
这项基于人群的研究基于芬兰国家食管-胃癌队列，纳入了2010年至2016年期间在芬兰接受胃癌胃切除术的所有18岁及以上患者。为了分类和描述不同的术后结果，分别使用了ECCG和GCCG的并发症清单。
该研究分析了1115例患者。根据GCCG分类，术后90天并发症的发生率为23.0%（504例个体并发症），根据ECCG分类为43.0%（1084例个体并发症）。两种分类方法在并发症报告方面的大多数显著差异在于心律失常、感染和心肌梗死，GCCG分类报告的发生率较低。此外，还记录了仅在ECCG中定义而不在GCCG中的13种个体并发症类型中发生的131例并发症。
本研究表明，在评估胃切除术并发症方面，ECCG分类比GCCG分类更全面、更敏感。在胃切除术的背景下，使用ECCG分类可能更可取。
