Risk assessment of postoperative complications of radical gastrectomy

HU Xiang; ZHANG Chi

doi:10.19538/j.cjps.issn1005-2208.2017.04.03

Abstract：Anastomotic leakage,pancreatic leakage and abdominal abscess are the most common complications after gastrectomy,and the complication rate is about 20% and mortality rate is about 1%. The risk factors such as elder patients,obesity and comorbidities may improve the incidence of mortality and complications. The factors are evaluation index of poor prognosis after operation. Postoperative complications criteria of gastric surgery is mainly used Clavien-Dindo classification of surgical complications as international standard. 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. The classifications of postoperative complications criteria are adopted widely large-scale evidence-based medical clinical trials of gastric cancer in Japan. PS,ASA, POSSUM,E-PASS,APACHE- Ⅱ,Charlson weighted index of comorbidities(WIC),Frailty score are used in predicting postoperative mortality and morbidity in gastric cancer patients. The risk factors are assigned points in scoring systems to objectively evaluate risk of surgery,and the surgical operation methods are one of the risk factors on the basis of the scoring systems. Surgeons should use the scoring systems reasonably for choosing reasonable surgical methods and perioperative management.