Analysis of Risk Factors and Clavien-Dindo Classification System for Complications after Total Gastrectomy

Tang Huazhen, Zheng Zhi, Yin Jie, Cai Jun, Zhang Jun and Zhang Zhongtao

Department of Surgery, Capital Medical University, China

^*Correspondance to: Zhang Jun 

 PDF  Full Text DOI: 10.25107/2474-1647.2577

Abstract

Purpose: To investigate risk factors and Clavien-Dindo classification system for complications after radical total gastrectomy for gastric cancer. Methods and Materials: Clinical data of 133 patients with gastric cancer who underwent radical total gastrectomy in our hospital from January 2012 to January 2017 were retrospectively analyzed. The complications after total gastrectomy was analyzed according to the Clavien-Dindo classification system and risk factors for postoperative complications were assessed by using the logistic regression model. Results: According to the Clavien-Dindo classification system, grade II had the highest incidence. The multivariate logistic regression analysis revealed that perioperative blood transfusion (odds ratio (OR) =16.08, 95% Confidence Interval (CI): 4.80 to 53.81, P=0.001) and postoperative albumin level (OR=3.34, 95% CI: 1.13 to 9.87, P=0.029) were independent risk factors for postoperative complications. The TNM staging (OR=0.08, 95% CI: 0.01 to 0.63, P=0.016), N stage (OR=0.12, 95% CI: 0.01 to 1.28, P=0.017), and perioperative blood transfusion (OR=4.69, 95% CI: 1.58 to 13.92, P=0.023) were independent risk factors, influencing severe complications in the multivariate analysis. Conclusion: The Clavien-Dindo classification system showed that grade II had the highest incidence, mainly including abdominal infection and abdominal hemorrhage. Furthermore, the majority of severe complications were related to anastomotic leakage. Postoperative blood transfusion and postoperative albumin level <30 g/l were identified as independent risk factors for postoperative complications. Moreover, TNM stage III, N3 stage, and postoperative blood transfusion were noted as independent risk factors for severe complications.

Keywords

Gastric cancer; Total gastrectomy; Postoperative complications; Clavien–Dindo classification; Risk factors

Cite the article

Huazhen T, Zhi Z, Jie Y, Jun C, Jun Z, Zhongtao Z. Analysis of Risk Factors and Clavien-Dindo Classification System for Complications after Total Gastrectomy. Clin Surg. 2019; 4: 2577..