Preoperative C-reactive protein and operative blood loss predict poor prognosis in patients with gastric cancer after laparoscopy-assisted gastrectomy

Autor:	Yuji Toiyama, Hiromi Yasuda, Koji Tanaka, Masato Kusunoki, Susumu Saigusa, Yoshito Ishino, Yasuhiko Mohri, Masaki Ohi
Rok vydání:	2014
Předmět:	medicine.medical_specialty Surgical stress Multivariate analysis biology business.industry medicine.medical_treatment C-reactive protein Postoperative complication Cancer Retrospective cohort study General Medicine Perioperative medicine.disease Surgery medicine biology.protein Gastrectomy business
Zdroj:	Asian Journal of Endoscopic Surgery. 7:287-294
ISSN:	1758-5902
DOI:	10.1111/ases.12126
Popis:	Introduction The aim of this study was to clarify the factors associated with postoperative complications and prognoses following laparoscopy-assisted gastrectomy for gastric cancer. Methods A total of 214 patients who underwent laparoscopy-assisted gastrectomy for gastric cancer were enrolled in this retrospective study. Factors that were potentially associated with postoperative complications and prognosis were assessed using the following clinical and perioperative parameters: the Estimation of Physiologic Ability and Surgical Stress scoring system, the Prognostic Nutritional Index, and the Clavien–Dindo classification. Results Postoperative complications developed in 18.7% of patients. Blood loss ≥ 1% of body weight was significantly correlated with anastomotic leakage (P = 0.0108). Severe complications, based on the Clavien–Dindo classification, were more frequent in patients with proximal or total gastrectomies (P = 0.0324). A preoperative C-reactive protein level > 0.5 mg/dL, blood loss > 1% of body weight, age ≥ 70 years at the time of operation, and an Estimation of Physiologic Ability and Surgical Stress score ≥ 0.2 were significantly correlated with poor prognosis. Multivariate analysis revealed that two of these factors, preoperative C-reactive protein level ≥ 0.5 mg/dL and operative blood loss ≥ 1% of body weight, were independent prognostic factors (P = 0.0376 and P = 0.0112, respectively). The Prognostic Nutritional Index had no significant correlation with prognosis or the occurrence of postoperative complications. Conclusion Operative blood loss ≥ 1% of body weight and type of resection were associated with an increased frequency of postoperative complications, while preoperative C-reactive protein levels and operative blood loss may be prognostic predictors for gastric cancer patients following laparoscopy-assisted gastrectomy.
Databáze:	OpenAIRE
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