Diagnosis and risk assessment of postoperative complications of gastric cancer in Japan and Korea.
- Author:
Xiang HU
1
;
Chi ZHANG
Author Information
1. Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China. g.shuxian@aliyun.com.
- Publication Type:Journal Article
- MeSH:
APACHE;
Gastrectomy;
adverse effects;
methods;
Health Status Indicators;
Humans;
Japan;
Korea;
Lymph Node Excision;
adverse effects;
Patient Care Planning;
standards;
Perioperative Care;
methods;
Postoperative Complications;
classification;
diagnosis;
mortality;
prevention & control;
Prognosis;
Risk Assessment;
methods;
Risk Factors;
Stomach Neoplasms;
complications;
surgery
- From:
Chinese Journal of Gastrointestinal Surgery
2017;20(2):129-134
- CountryChina
- Language:Chinese
-
Abstract:
Radical surgery of gastric cancer (D2 lymph node dissection) as the standard operation is widely used in clinical practice and satisfactory prognosis can be obtained in patients who receive radical gastrectomy. But surgical invasion can cause high morbidity of complications and mortality. The data of large-scale evidence-based medical clinical trials and large databases in Japan and Korea showed that anastomotic leakage, pancreatic leakage and abdominal abscess were the most common complications after gastrectomy, and the morbidity of complication was about 20% and mortality was about 1%. The risk factors such as elderly, obesity, and comorbidities may increase the morbidity of complications and mortality, and these factors were regarded as poor predictors after operation. Postoperative complications criteria of gastric cancer surgery is mainly used with Clavien-Dindo classification of surgical complications as international standard, and this criteria is also used in Korea. The postoperative complications are evaluated with the Common Terminology Criteria for Adverse Events (CTCAE v4.0) and Japanese Clinical Oncology Group(JCOG) postoperative complications criteria for grading definitions of postoperative complications after gastric surgery in Japan. These classifications of postoperative complications criteria were adopted widely in Japan with large-scale evidence-based medical clinical trials of gastric cancer. PS, ASA, POSSUM, E-PASS, APACHE-II(, Charison weighted index of comorbidities (WIC), Frailty Score was used in predicting postoperative mortality and morbidity in gastric cancer patients. These risk factors were assigned points in scoring systems to objectively evaluate risk of surgery, and surgical operation method was one of the risk factors on the basis of these scoring systems. We can use these scoring systems for choosing reasonable surgical methods and proper perioperative management.
