Postoperative complications requiring relaparotomies after 700 gastrectomies performed for gastric cancer
| Autor: | I. B. Shchepotin, Vyacheslav A. Chorny, Mohsen Shabahang, Russell J. Nauta, Stephen R.T. Evans, Robert R. Buras |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Adenocarcinoma Postoperative Complications Stomach Neoplasms Laparotomy medicine Humans Aged business.industry General surgery Stomach Cancer General Medicine Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Anastomotic leakage Female Gastrectomy business Complication |
| Zdroj: | The American Journal of Surgery. 171:270-273 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/s0002-9610(97)89567-0 |
| Popis: | Background Prevention of fatal postoperative complications and improved management of patients with complications are important means of increased survival in gastric cancer patients. Patients and methods A study of 700 patients undergoing gastrectomy was performed to examine factors that contributed to a high rate of postoperative complications. Results Of 700 patients undergoing gastrectomy for adenocarcinoma, 40 (5.7%) underwent reexploration because of serious complications. The frequency of the relaparotomies varied from 2.1% and 4.4% after regular subtotal and total gastrectomies, respectively, to 20% and 30.4% after palliative and conventional total gastrectomies, respectively. The complications that required reexploration most frequently were anastomotic leakage and incompetence of sutures (11, 27.5%), intra-abdominal abscesses (8, 20%), and pancreatic necrosis (7, 17.5%). A combination of preventive measures allowed the attainment of low rates of esophagojejunal anastomotic leakage (0.8%). Conclusion We believe that the decision to perform an urgent reexploration, based on clinical findings, should generally be made by a group of experienced surgeons (not only the primary surgeon). Timely relaparotomy prevented death in 37.5% of the patients with serious acute postoperative complications. |
| Databáze: | OpenAIRE |
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