Clavien-Dindo grading and risk factor analysis of short-term complications after distal gastrectomy
10.3760/cma.j.cn115396-20231107-00130
- VernacularTitle:远端胃大部切除术后短期并发症的Clavien-Dindo分级及危险因素分析
- Author:
Wei SUN
1
;
Zhongtao ZHANG
Author Information
1. 首都医科大学附属北京友谊医院普外科，北京 100050
- Keywords:
Stomach neoplasms;
Postoperative complications;
Risk factors;
Distal gastrectomy;
Clavien-Dindo
- From:
International Journal of Surgery
2024;51(1):22-27
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the Clavien-Dindo (CD) classfication of short-term (within 30 days postoperative) complications of distal major gastrectomy (DG) and the associated risk factors affecting this classification.Methods:A retrospective analysis was conducted on the clinical data of 230 patients with gastric cancer who underwent DG completed by the same operator at Beijing Friendship Hospital, Capital Medical University from January 2016 to December 2021. There were 159 males (69.1%) and 71 females (30.9%), aged from 31 to 80 years, with an average age of (61.69±10.91) years, all patients average body mass index was (23.59±3.46) kg/m 2. Chi-square test or Fisher exact probability method was used to compare the count data between groups, and rank sum test was used to compare the rank data between groups. Multiple factors were analyzed by stepwise Logistic regression. Results:In this study, a total of 30 cases (13.0%) experienced CD grade Ⅱ or higher postoperative complications. Among them, 20 cases (66.7%) were grade Ⅱ, 8 cases (26.7%) were grade Ⅲ, and 2 cases (6.6%) were grade Ⅳ, Among the 30 patients with complications, there were 2 cases of simple anastomotic leakage, 2 cases of anastomotic bleeding, 3 cases of duodenal stump leakage, 2 cases of intra-abdominal infection, 6 cases of intestinal obstruction, 5 cases of pulmonary infection, 2 cases of incision infection, 2 cases of delayed gastric emptying, 3 cases of pulmonary infection combined with atelectasis, 2 cases of anastomotic leakage combined with intra-abdominal infection, and 1 case of pulmonary infection and intra-abdominal infection combined with intestinal obstruction. Pulmonary infection, intestinal obstruction, and anastomotic leakage were the main postoperative complications of DG. The surgical approach was an independent risk factor for postoperative complications ( P<0.05), and there was no statistically significant difference in the grade of postoperative complications of patients with different surgical methods( P>0.05). Conclusions:Pulmonary infection, intestinal obstruction, abdominal infection, and anastomotic leakage are the main postoperative complications of DG. The independent risk factor for complications is the surgical approach, but the surgical approach does not affect the CD grading of complications.
