Management of an Intra-abdominal Fluid Collection after Gastric Cancer Surgery.
10.5230/jkgca.2008.8.4.256
- Author:
Young Min JEON
1
;
Hye Seong AHN
;
Moon Won YOO
;
Jae Jin CHO
;
Jeong Min LEE
;
Huk Joon LEE
;
Han Kwang YANG
;
Kuhn Uk LEE
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hkyang@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Intra-abdominla fluid collection;
Percutaneous drainage
- MeSH:
Bacteremia;
Body Mass Index;
Fever;
Humans;
Incidence;
Leukocytosis;
Liver Diseases;
Lymph Node Excision;
Risk Factors;
Stomach Neoplasms
- From:Journal of the Korean Gastric Cancer Association
2008;8(4):256-261
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. MATERIALS AND METHODS: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. RESULTS: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, kg/m2) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. CONCLUSION: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.