Impact of postoperative complications on clinical outcomes after gastrectomy for cancer: multicentre study

作者：Sander J M van Hootegem, Margrietha van der Linde, Marcel Schneider, Jeesun Kim, Felix Berlth, Yutaka Sugita, Peter Grimminger, Gian Luca Baiocchi, Giovanni De Manzoni, Maria Bencivenga, Suzanne S. Gisbertz, Souya Nunobe, Han‐Kwang Yang, Christian A. Gutschow, Sjoerd M. Lagarde, Hester F. Lingsma, Bas P. L. Wijnhoven, Hidde Overtoom, Ines Gockel, René Thieme, Ewen A. Griffiths, William Butterworth, Henrik Nienhüser, Beat Müller, Nerma Crnovrsanin, Felix Nickel, Suzanne S. Gisbertz, Mark I. van Berge Henegouwen, Philip H. Pucher, Kashuf Khan, Asif Chaudry, Pranav Patel, Manuel Pera, Mariagiulia Dal Cero, Carlos Garcı́a, Guillermo Martinez Salinas, P Kassab, Osvaldo Antônio Prado Castro, Enrique Norero, Paul Wisniowski, Luke R. Putnam, Pietro Maria Lombardi, Giovanni Ferrari, Rita Gudaitytė, Almantas Maleckas, Leanne Prodehl, Antonio Castaldi, Michel Prudhomme, Simone Giacopuzzi, Riccardo Rosati, Francesco Puccetti, Domenico D’Ugo, Dániel Gerö, Hyuk-Joon Lee, Guillaume Piessen, Justine Lerooy, Johanna W. van Sandick, Suzanne S. Gisbertz, Mark I. van Berge Henegouwen, Jessie A. Elliott, Paolo Morgagni, A. H. Hölscher, Martin Hemmerich, Stefan Mönig, Mickaël Chevallay, Piotr Kołodziejczyk, Henk H. Hartgrink, Paulo Costa, Filipe Castro Borges, Andrew Davies, Cara Baker, William Allum, Sacheen Kumar, Wojciech Polkowski, Karol Rawicz‐Pruszyński, Uberto Fumagalli Romario, Stefano De Pascale, Antonio Tarasconi, Daniel Reim, Ilaria Pergolini, Lúcio Lara Santos, Pedro Martins, Alberto Biondi, Riccardo Rosati, Maurizio Degiuli, Rossella Reddavid, Wojciech Kielan, Paul Magnus Schneider, Thomas J. Murphy · 发表于：British journal of surgery · 年份：2025 · DOI：10.1093/bjs/znaf043 · 被引用次数：16 · 研究领域：Gastric Cancer Management and Outcomes、Helicobacter pylori-related gastroenterology studies、Bariatric Surgery and Outcomes

BACKGROUND: To reduce the clinical and economic burden of complications after gastrectomy for gastric cancer, specific complications should be targeted to effectively allocate healthcare resources for quality improvement and preventive measures. The aim of this study was to assess the impact of complications on clinical outcomes. METHODS: This was a retrospective multicentre study of patients who underwent (sub)total gastrectomy for gastric or junctional adenocarcinoma at 43 centres in 16 countries between 2017 and 2021. Outcomes were escalation of care, reoperation, prolonged hospital stay (greater than the 75th percentile), readmission, and 30-day mortality. Adjusted relative risks and population attributable fractions were estimated for specific complication-outcome pairs. The population attributable fraction represents the percentage reduction in the frequency of an adverse outcome if a complication could be completely prevented in the population. RESULTS: In total, 7829 patients were included. Postoperative complications occurred in 1884 patients (24.1%). The most frequent complications were pulmonary complications (436 patients (5.6%)), anastomotic leakage (363 patients (4.6%)), and abdominal collection (301 patients (3.8%)). Anastomotic leakage, cardiac complications, and pulmonary complications had the greatest impact on 30-day mortality (population attributable fraction 26.6% (95% c.i. 14.5% to 38.6%), 18.7% (95% c.i. 9.4% to 28.0%), and 15.6% (95% c.i. 12.0% to 30.0...