Postoperative Delayed Emptying after Total, Subtotal, or Distal Gastrectomy for Gastric Cancer - a Population-based Study
Junttila, Anna; Helminen, Olli; Helmiö, Mika; Huhta, Heikki; Jalkanen, Aapo; Kallio, Raija; Koivukangas, Vesa; Kokkola, Arto; Laine, Simo; Lietzen, Elina; Louhimo, Johanna; Meriläinen, Sanna; Pohjanen, Vesa-Matti; Rantanen, Tuomo; Ristimäki, Ari; Räsänen, Jari V; Saarnio, Juha; Sihvo, Eero; Toikkanen, Vesa; Tyrväinen, Tuula; Valtola, Antti; Kauppila, Joonas H; On behalf of the Finnish National Esophago-Gastric Cancer Cohort Group (2024-05-03)
Springer
03.05.2024
Junttila, A., Helminen, O., Helmiö, M., Huhta, H., Jalkanen, A., Kallio, R., Koivukangas, V., Kokkola, A., Laine, S., Lietzen, E., Louhimo, J., Meriläinen, S., Pohjanen, V.-M., Rantanen, T., Ristimäki, A., Räsänen, J. V., Saarnio, J., Sihvo, E., Toikkanen, V., … Kauppila, J. H. (2024). Postoperative delayed emptying after total, subtotal, or distal gastrectomy for gastric cancer: A population-based study. Journal of Gastrointestinal Surgery, 28(7), 1083–1088. https://doi.org/10.1016/j.gassur.2024.04.026
https://creativecommons.org/licenses/by/4.0/
© 2024 The Author(s). Published by Elsevier Inc. on behalf of Society for Surgery of the Alimentary Tract. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
© 2024 The Author(s). Published by Elsevier Inc. on behalf of Society for Surgery of the Alimentary Tract. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202405223822
https://urn.fi/URN:NBN:fi:oulu-202405223822
Tiivistelmä
Abstract
Background:
This study aimed to examine the rate of delayed emptying and other 90-day postoperative complications after total, subtotal, and distal gastrectomies for gastric adenocarcinoma in a population-based setting.
Methods:
This study included all patients who underwent total, subtotal, or distal gastrectomy for gastric cancer in Finland in 2005–2016, with follow-up until December 31, 2019. Logistic regression provided the odds ratios with 95% CIs of 90-day mortality. The results were adjusted for age, sex, year of surgery, comorbidities, pathologic stage, and neoadjuvant therapy.
Results:
A total of 2058 patients underwent total (n = 1227), subtotal (n = 450), or distal (n = 381) gastrectomy. In the total, subtotal, and distal gastrectomy groups, the rates of 90-day delayed emptying were 1.7%, 1.3%, and 2.1% in the whole cohort and 1.6%, 1.8%, and 3.5% in the subgroup analysis of R0 resections, respectively. The resection type was not associated with the risk of delayed emptying. Subtotal gastrectomy was associated with a lower risk of major complications and reoperations, whereas distal gastrectomy was associated with a lower risk of anastomotic complications.
Conclusion:
The extent of resection did not affect delayed emptying, whereas fewer postoperative complications were observed after subtotal or distal gastrectomy than after total gastrectomy.
Background:
This study aimed to examine the rate of delayed emptying and other 90-day postoperative complications after total, subtotal, and distal gastrectomies for gastric adenocarcinoma in a population-based setting.
Methods:
This study included all patients who underwent total, subtotal, or distal gastrectomy for gastric cancer in Finland in 2005–2016, with follow-up until December 31, 2019. Logistic regression provided the odds ratios with 95% CIs of 90-day mortality. The results were adjusted for age, sex, year of surgery, comorbidities, pathologic stage, and neoadjuvant therapy.
Results:
A total of 2058 patients underwent total (n = 1227), subtotal (n = 450), or distal (n = 381) gastrectomy. In the total, subtotal, and distal gastrectomy groups, the rates of 90-day delayed emptying were 1.7%, 1.3%, and 2.1% in the whole cohort and 1.6%, 1.8%, and 3.5% in the subgroup analysis of R0 resections, respectively. The resection type was not associated with the risk of delayed emptying. Subtotal gastrectomy was associated with a lower risk of major complications and reoperations, whereas distal gastrectomy was associated with a lower risk of anastomotic complications.
Conclusion:
The extent of resection did not affect delayed emptying, whereas fewer postoperative complications were observed after subtotal or distal gastrectomy than after total gastrectomy.
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