Evaluation of factors related to Clavien. Dindo 3 and above complications in patients undergoing gastrectomy due to gastric cancer

Abstract

AIM: In our study, we aimed to evaluate the complications after total gastrectomy by Clavien-Dindo classification and to determine the related risk factors.

METHODS: Patients who underwent total gastrectomy due to gastric cancer between 2015-2019 were included in the study. Patients were divided into two groups according to postoperative complication classification Clavien Dindo, those with 3 or higher were Group 1 and the others were Group 2. Demographic and clinical features, laboratory parameters, tumor characteristics, postoperative results and mean survival were compared in the groups. Risk factors for Clavien Dindo 3 and above were analyzed by univariate analysis and multivariate logistic regression analysis.

RESULTS: A total of 104 patients participated in our study. Group1 consisted of 25 and Group2 consisted of 79 patients. Male sex was high in both groups (52% vs67.1%, p:0.130). BMI (26 vs 23, p:0.023), albumin (3.24 vs 3.51, p:0,040), postoperative mortality (%28vs% 2.5, p:0.001), postoperative duration of hospitalization (17.60vs9.25 days, p:0.000) were different between the groups, but total survival (month) was not statistically significantly different (19.60vs18.53, p:0.377). In multivariate analysis, tumor Stage 3C (OR =0.177,95% CI = (0.067-0.468), p:0.000), operation duration ≥240 min (OR =2.105,95% CI = (1.080-4.100, p:0.029) and application of neoadjuvant treatment (HR =3.026,95%CI =(1.682-5.446), p:0.000) were indepent risk factors.

DISCUSSION: In conclusion, obesity, hypoalbuminemia, anemia, tumor stage, duration of operation, and taking neoadjuvant therapy were closely related to postoperative complications. Although the development of postoperative complication increased the length of hospitalization and postoperative mortality, it did not decrease survival in the long term.