TY - JOUR
T1 - Incidence and grading of complications after gastrectomy for cancer using the GASTRODATA registry a european retrospective observational study
AU - Baiocchi, Gian Luca
AU - Giacopuzzi, Simone
AU - Reim, Daniel
AU - Piessen, Guillaume
AU - Da Costa, Paulo Matos
AU - Reynolds, John V.
AU - Meyer, Hans Joachim
AU - Morgagni, Paolo
AU - Gockel, Ines
AU - Santos, Lucio Lara
AU - Jensen, Lone Susanne
AU - Murphy, Thomas
AU - D'Ugo, Domenico
AU - Rosati, Riccardo
AU - Romario, Uberto Fumagalli
AU - Degiuli, Maurizio
AU - Kielan, Wojciech
AU - Monig, Stefan
AU - Kołodziejczyk, Piotr
AU - Polkowski, Wojciech
AU - Pera, Manuel
AU - Schneider, Paul M.
AU - Wijnhoven, Bas
AU - De Steur, Wobbe O.
AU - Gisbertz, Suzanne S.
AU - Hartgrink, Henk
AU - Van Sandick, Johanna W.
AU - Botticini, Maristella
AU - Holscher, Arnulf H.
AU - Allum, William
AU - De Manzoni, Giovanni
PY - 2020/11
Y1 - 2020/11
N2 - Objective: Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe. Summary Background Data: The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries. Methods: Using a secure online platform (www.gastrodata.org), referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period. Results: A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications' incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and ComprehensiveComplications Indexwere IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively. Conclusions: The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications.
AB - Objective: Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe. Summary Background Data: The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries. Methods: Using a secure online platform (www.gastrodata.org), referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period. Results: A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications' incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and ComprehensiveComplications Indexwere IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively. Conclusions: The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications.
KW - Complications
KW - Gastrectomy
KW - Gastric cancer
KW - International database
KW - Standardized outcome
UR - http://www.scopus.com/inward/record.url?scp=85092944497&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000004341
DO - 10.1097/SLA.0000000000004341
M3 - Article
C2 - 32925254
AN - SCOPUS:85092944497
VL - 272
SP - 807
EP - 813
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
IS - 5
ER -