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Risk factors and learning curve associated with postoperative morbidity of laparoscopic total gastrectomy for gastric carcinoma
- Source :
- Annals of surgical oncology. 21(9)
- Publication Year :
- 2013
-
Abstract
- Laparoscopic total gastrectomy (LTG) is a challenging surgical procedure that has substantial technical difficulties and complications. In this study, we investigated risk factors for morbidity and mortality after LTG, and the learning curve associated with postoperative morbidity. Prospectively constructed data of 203 patients undergoing LTG between 2004 and 2013 were retrospectively reviewed. The multivariate logistic regression model was used to analyze risk factors for postoperative morbidity. The Cumulative Sum (CUSUM) technique was used to assess the learning curve. Postoperative morbidity and mortality after LTG was 18.7 and 1.5 %, respectively. Of 38 patients with postoperative morbidity, 7 (3.4 %) were managed with reoperation, 8 (4.0 %) with radiologic or endoscopic intervention, and 23 (11.3 %) with a conservative treatment. Of local complications, gastrointestinal bleeding was the most common (12 patients), followed by anastomosis leakage (9 patients) and intra-abdominal abscess (9 patients). Respiratory complication was the most common of the systemic complications. There were 17 cases (8.4 %) of complications exceeding grade III severity, of which anastomosis leakage was the most common. CUSUM analysis showed that postoperative morbidity reached a plateau after around 45 cases. Univariate and multivariate analyses revealed that old age (over 65 years of age) and surgical experience (
- Subjects :
- Male
Gastrointestinal bleeding
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
Anastomosis
Risk Assessment
Postoperative Complications
Gastrectomy
Risk Factors
Stomach Neoplasms
Gastroscopy
medicine
Humans
Prospective Studies
Abscess
Prospective cohort study
Laparoscopy
Neoplasm Staging
medicine.diagnostic_test
business.industry
General surgery
Middle Aged
medicine.disease
Prognosis
Surgery
Oncology
Female
Morbidity
business
Risk assessment
Learning Curve
Follow-Up Studies
Subjects
Details
- ISSN :
- 15344681
- Volume :
- 21
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Annals of surgical oncology
- Accession number :
- edsair.doi.dedup.....766dafa0155a2888453f9978cf6b0ad2