Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014
Background: The aim of this study was to evaluate postoperative morbidity, mortality, and failure to rescue following complications after radical resection for gastric cancer. Methods: A retrospective analysis of the surgical database of patients with gastroesophageal malignancies at our institution...
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| Format: | Article |
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MDPI AG
2020-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/7/1953 |
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| author | Christian Galata Ulrich Ronellenfitsch Susanne Blank Christoph Reißfelder Julia Hardt |
| author_facet | Christian Galata Ulrich Ronellenfitsch Susanne Blank Christoph Reißfelder Julia Hardt |
| author_sort | Christian Galata |
| collection | DOAJ |
| description | Background: The aim of this study was to evaluate postoperative morbidity, mortality, and failure to rescue following complications after radical resection for gastric cancer. Methods: A retrospective analysis of the surgical database of patients with gastroesophageal malignancies at our institution was performed. All consecutive patients undergoing R0 gastrectomy for pT1–4 M0 gastric adenocarcinoma between October 1972 and February 2014 were eligible for this analysis. Patients were divided into two groups according to the date of surgery: an early cohort operated on from 1972–1992 and a late cohort operated on from 1993–2014. Both groups were compared regarding patient characteristics and surgical outcomes. Results: A total of 1107 patients were included. Postoperative mortality was more than twice as high in patients operated on from 1972–1992 compared to patients operated on from 1993–2014 (6.8% vs. 3.2%, <i>p</i> = 0.017). Between both groups, no significant difference in failure to rescue after major surgical complications was observed (20.8% vs. 20.5%, <i>p</i> = 1.000). Failure to rescue after other surgical and non-surgical complications was 37.8% in the early cohort compared to 3.2% in the late cohort (<i>p</i> < 0.001). Non-surgical complications accounted for 71.2% of lethal complications between 1972 and 1992, but only for 18.2% of lethal complications between 1993 and 2014 (<i>p</i> = 0.002). Conclusion: In the course of four decades, postoperative mortality after radical resection for gastric cancer has more than halved. In this cohort, the reason for this decrease was reduced mortality due to non-surgical complications. Major surgical morbidity after gastrectomy remains challenging. |
| first_indexed | 2024-03-10T18:24:02Z |
| format | Article |
| id | doaj.art-be544aa2264141fe83a7d4cfe6530c62 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T18:24:02Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-be544aa2264141fe83a7d4cfe6530c622023-11-20T07:12:04ZengMDPI AGCancers2072-66942020-07-01127195310.3390/cancers12071953Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014Christian Galata0Ulrich Ronellenfitsch1Susanne Blank2Christoph Reißfelder3Julia Hardt4Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, GermanyDepartment of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, D-06120 Halle (Saale), GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, GermanyDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, D-68167 Mannheim, GermanyBackground: The aim of this study was to evaluate postoperative morbidity, mortality, and failure to rescue following complications after radical resection for gastric cancer. Methods: A retrospective analysis of the surgical database of patients with gastroesophageal malignancies at our institution was performed. All consecutive patients undergoing R0 gastrectomy for pT1–4 M0 gastric adenocarcinoma between October 1972 and February 2014 were eligible for this analysis. Patients were divided into two groups according to the date of surgery: an early cohort operated on from 1972–1992 and a late cohort operated on from 1993–2014. Both groups were compared regarding patient characteristics and surgical outcomes. Results: A total of 1107 patients were included. Postoperative mortality was more than twice as high in patients operated on from 1972–1992 compared to patients operated on from 1993–2014 (6.8% vs. 3.2%, <i>p</i> = 0.017). Between both groups, no significant difference in failure to rescue after major surgical complications was observed (20.8% vs. 20.5%, <i>p</i> = 1.000). Failure to rescue after other surgical and non-surgical complications was 37.8% in the early cohort compared to 3.2% in the late cohort (<i>p</i> < 0.001). Non-surgical complications accounted for 71.2% of lethal complications between 1972 and 1992, but only for 18.2% of lethal complications between 1993 and 2014 (<i>p</i> = 0.002). Conclusion: In the course of four decades, postoperative mortality after radical resection for gastric cancer has more than halved. In this cohort, the reason for this decrease was reduced mortality due to non-surgical complications. Major surgical morbidity after gastrectomy remains challenging.https://www.mdpi.com/2072-6694/12/7/1953gastric cancergastrectomycomplicationsmortalityfailure to rescue |
| spellingShingle | Christian Galata Ulrich Ronellenfitsch Susanne Blank Christoph Reißfelder Julia Hardt Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 Cancers gastric cancer gastrectomy complications mortality failure to rescue |
| title | Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 |
| title_full | Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 |
| title_fullStr | Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 |
| title_full_unstemmed | Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 |
| title_short | Postoperative Morbidity and Failure to Rescue in Surgery for Gastric Cancer: A Single Center Retrospective Cohort Study of 1107 Patients from 1972 to 2014 |
| title_sort | postoperative morbidity and failure to rescue in surgery for gastric cancer a single center retrospective cohort study of 1107 patients from 1972 to 2014 |
| topic | gastric cancer gastrectomy complications mortality failure to rescue |
| url | https://www.mdpi.com/2072-6694/12/7/1953 |
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