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Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute

Authors
 Sung Jin Oh  ;  Won Beom Choi  ;  Jyewon Song  ;  Woo Jin Hyung  ;  Seung Ho Choi  ;  Sung Hoon Noh 
Citation
 Journal of Gastrointestinal Surgery, Vol.13(2) : 239-245, 2009 
Journal Title
 Journal of Gastrointestinal Surgery 
ISSN
 1091-255X 
Issue Date
2009
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery* ; Adult ; Aged ; Cohort Studies ; Female ; Gastrectomy/adverse effects* ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Quality of Life ; Reoperation ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Survival Rate ; Time Factors
Keywords
Gastric cancer ; Complication ; Reoperation ; Mortality
Abstract
INTRODUCTION: Morbidity and mortality rates following gastric cancer surgery are still high. The present study documented complications requiring reoperation after gastrectomy for gastric cancer and described surgical management for each complication. MATERIALS AND METHODS: Between 1987 and 2004, 8,033 patients underwent gastrectomy at the Department of Surgery, College of Medicine, Yonsei University, and the records were reviewed. RESULTS AND DISCUSSION: The most frequent complication was intestinal obstruction (88 patients, 54.3%), followed by intraabdominal bleeding (15, 9.3%), wound dehiscence or evisceration (15, 9.3%), incisional hernia (15, 9.3%), anastomotic leakage (seven, 4.2%), acalculous cholecystitis (five, 3.1%), duodenal stump leakage (five, 3.1%), intraabdominal abscess without leakage (five, 3.1%), bowel perforation (five, 3.1%), bile peritonitis due to hepatic duct injury (one, 0.6%), and biliary stricture (one, 0.6%). There were ten cases of hospital mortality (6.2%) from intraabdominal bleeding (four patients), intestinal obstruction (four patients), and anastomotic leakage (two patients). The most common long-term complication requiring reoperation was intestinal obstruction (69, 75.8%) due to adhesive formation rather than technical failure, while short-term complications were surgery-related and associated with high hospital mortality (14.1%). CONCLUSION: Proper preoperative preparation and faultless surgical skills are required during initial surgery to reduce complications and the need for reoperation.
Full Text
http://link.springer.com/article/10.1007%2Fs11605-008-0716-3
DOI
10.1007/s11605-008-0716-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Song, Jye Won(송재원)
Oh, Sung Jin(오성진)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
Choi, Won Beom(최원범)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103520
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