Risk Factors for Reoperation Following Radical Gastrectomy in Gastric Cancer Patients

2021 ◽  
pp. 000313482110508
Author(s):  
Dong-Hwan Kim ◽  
Ji-Ho Park ◽  
Tae Han Kim ◽  
Eun-Jung Jung ◽  
Chi-Young Jeong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Radical Gastrectomy ◽  
Factors Associated ◽  
Abdominal Bleeding ◽  
Independent Risk Factors ◽  
Gastric Cancer Patients

Background Reoperation due to elective surgery complications is very mentally, physically, and economically detrimental to patients. This study investigated the potential risk factors associated with early reoperation after radical gastrectomy in gastric cancer patients and included an in-depth analysis of these risk factors. Methods This retrospective study reviewed 1568 patients with gastric cancer. Grade 3 or greater complications were defined as severe. Any factors related to reoperation after radical gastrectomy were analyzed in patients with severe local complications. Results Among 1537 patients undergoing radical gastrectomy, 115 (7.5%) patients had severe postoperative complications, 98 (6.38%) of whom experienced severe local complications. The most common local complication was anastomotic leakage (31, 2.02%), followed by intra-abdominal abscess (30, 1.95%), pancreatic leakage (22, 1.43%), duodenal stump leakage (18, 1.17%), intra-abdominal bleeding (12, .78%), intraluminal bleeding (8, .52%), small bowel obstruction (5, .32%), and chyle leakage (3, .19%). Of these patients, 26 (1.69%) underwent reoperation, and 6 (.39%) died. In the univariate analysis of clinical factors related to reoperation, intra-abdominal bleeding and small bowel obstruction were risk factors for reoperation, and intra-abdominal bleeding (odds ratio [OR] = 9.57, confidence interval [CI] = 2.65-40.20, P < .001) and small bowel obstruction (OR = 19.14, CI = 2.60-390.13, P = .011) were independent risk factors associated with reoperation in the multivariate analysis. Conclusion Intra-abdominal bleeding and small bowel obstruction are independent risk factors for reoperation following radical gastrectomy. Patients with postoperative intra-abdominal bleeding and small bowel obstruction need to be warned about reoperation.

scholarly journals Prediction of Small Bowel Obstruction Caused by Bezoars Using Risk Factor Categories on Multidetector Computed Tomographic Findings

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Lian-qin Kuang ◽  
Da-wei Zhao ◽  
Cheng Cheng ◽  
Yi Wang
Keyword(s):  
Risk Factor ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Mean Values ◽  
Factors Associated ◽  
Computed Tomographic ◽  
Ct Attenuation ◽  
Independent Risk Factors ◽  
The Mean

Objectives. The aim of this study was to detect factors associated with small bowel obstruction (SBO) caused by bezoars on multidetector computed tomographic findings.Methods. We retrospectively reviewed 61 patients who had bezoars in the small bowels on MDCT. The patients were divided into SBO patients group and non-SBO patients group. The mean values of the diameter, volume, and CT attenuation as well as location and characteristics of the bezoars were compared between the two groups. Multivariate analysis was performed to determine factors associated with SBO.Results. There were 32 patients (52.5%) in the SBO group and 29 patients (47.5%) in the non-SBO group. The bezoars in the SBO group had greater values of each mean diameter and mean volume than those in the non-SBO group (3.2±0.5 cm versus1.6±0.7 cm,P<0.0001,14.9±6.4 cm3versus2.5±2.7 cm3,P<0.0001, resp.) and had a lower CT attenuation than the non-SBO group (55.5±23.4versus173.0±68.0,P<0.0001). The SBO group had higher prevalence of phytobezoar appearance (75.0% versus 10.3%,P<0.0001). Major diameters of bezoar and phytobezoar were significant independent risk factors associated with SBO (odds ratio = 36.09, 8.26, resp., andP=0.0004, 0.044, resp.).Conclusions. Major diameter of bezoar or phytobezoar is a potential risk factor associated with SBO.

Small bowel obstruction: an unusual cause.

2007 ◽  
Vol 52 (3) ◽  
pp. 53-53
Author(s):  
MJ Steven ◽  
A Jabaar
Keyword(s):  
Risk Factors ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Clinical Features ◽  
Bowel Obstruction ◽  
Gastric Surgery

A bezoar is a tightly packed collection of partially digested or undigested material. When this material is vegetable matter it is known as a phytobezoar, when it is hair it is a trichobezoar and when it is medication a pharmacobezoar. Phytobezoars are a known cause of small bowel obstruction in patients who have had previous gastric surgery. Two cases of small bowel obstruction caused by phytobezoars are discussed in patients with no risk factors. The cause, clinical features and management of phytobezoars is reviewed in an attempt to increase awareness of this unusual cause of small bowel obstruction.

Prevalence and risk factors of mortality and morbidity after operation for adhesive postoperative small bowel obstruction

2008 ◽  
Vol 195 (6) ◽  
pp. 726-734 ◽  
Author(s):  
Jean-Jacques Duron ◽  
Sophie Tezenas du Montcel ◽  
Anne Berger ◽  
Fabrice Muscari ◽  
Henri Hennet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Mortality And Morbidity ◽  
Postoperative Small Bowel Obstruction

Bioresorbable Membrane to Reduce Postoperative Small Bowel Obstruction in Patients With Gastric Cancer

2008 ◽  
Vol 247 (5) ◽  
pp. 766-770 ◽  
Author(s):  
Shigeoki Hayashi ◽  
Tadatoshi Takayama ◽  
Hideki Masuda ◽  
Mitsugu Kochi ◽  
Yukimoto Ishii ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bioresorbable Membrane ◽  
Postoperative Small Bowel Obstruction

Diaphragm disease in emergency surgery

2020 ◽  
Vol 81 (3) ◽  
pp. 1-6
Author(s):  
Diwakar R Sarma ◽  
Pratik Bhattacharya
Keyword(s):  
Risk Factors ◽  
Small Intestine ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Laparotomy ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Acute Small Bowel Obstruction ◽  
Anti Inflammatory

Background/Aims Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form of non-steroidal anti-inflammatory drug-induced enteropathy, often presenting as acute small bowel obstruction. A systematic review was performed to identify risk factors and patient outcomes in histologically-proven diaphragm disease of the small intestine in patients undergoing emergency operation for small bowel obstruction. Methods A comprehensive search was performed between January 1975 and March 2019 using relevant MeSH terms. Studies were chosen based on predefined inclusion criteria. Diaphragm disease of the small intestine was defined as macroscopically detected thin diaphragm-like mucosal folding inside the lumen of the bowel. The parameters assessed included patient characteristics, duration of use of non-steroidal anti-inflammatory drugs, type of emergency surgery performed, complications, recurrence, presentation and diagnosis of diaphragm disease. Results A total of 21 studies were analysed which included 17 case reports, one case series, and three retrospective comparative studies. Overall 29 patients with diaphragm disease of the small bowel were reported following emergency laparotomy for small bowel obstruction. Use of non-steroidal anti-inflammatory drugs was noted in all cases with an average duration of 3–5 years. All patients presented acutely with features of small bowel obstruction and had emergency laparotomy, except one who underwent laparoscopic resection. In the comparative studies patients were more likely to be female and to have been taking non-steroidal anti-inflammatory drugs for more than 7 years. Conclusions This is a rare disease, difficult to diagnose and often confirmed by the intra-operative macroscopic appearance of circumferential stenosis of the bowel. Risk factors for developing small bowel diaphragm disease include long-term use of non-steroidal anti-inflammatory drugs, and female gender. Patients with this disease are at increased risk of developing acute small bowel obstruction, so early identification is important.

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