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Surgery Today

, Volume 41, Issue 3, pp 363–368 | Cite as

Predisposing factors and management of postoperative bleeding after radical gastrectomy for gastric carcinoma

  • Oh Jeong
  • Young Kyu Park
  • Seong Yeob Ryu
  • Dong Yi Kim
  • Ho Kun Kim
  • Mi Ran Jeong
Original Article

Abstract

Purpose

To promote proper management of postoperative bleeding, we investigated the clinical manifestations, predisposing factors, diagnostic approaches, and treatments of bleeding complications after gastric cancer surgery.

Methods

Using a prospectively constructed database, we reviewed retrospectively 39 patients who suffered bleeding complications from among a total 1027 patients who underwent surgery for gastric cancer between 2004 and 2008.

Results

Operating time (hazard ratio [HR] 1.842, 95% confidence interval [CI] 1.524–2.367) and body mass index (HR 1.454, 95% CI 1.128–1.792) were significant predisposing factors for postoperative bleeding after gastric cancer surgery. Luminal bleeding occurred in 16 patients: as simple anastomosis site bleeding, treated successfully with conservative or endoscopic treatment, in 13; and as pseudoaneurysmal bleeding in 3, treated successfully with surgery in 2, but resulting in the death of 1. Abdominal bleeding occurred in 23 patients, requiring surgery in 9 and arterial embolization in 1. The most common finding at reoperation was bleeding from the mesocolon surface. The mean hospital stay of patients with postoperative bleeding was 21 (±20) days.

Conclusions

Postoperative bleeding can be managed successfully with a tailored approach, considering its origins and clinical manifestations. Arterial pseudoaneurysms are a rare cause of luminal bleeding, but they can be fatal and should be suspected when extensive luminal bleeding presents after gastric cancer surgery.

Key words

Gastric cancer Postoperative bleeding Morbidity Predisposing factor 

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Copyright information

© Springer 2011

Authors and Affiliations

  • Oh Jeong
    • 1
  • Young Kyu Park
    • 1
  • Seong Yeob Ryu
    • 1
  • Dong Yi Kim
    • 1
  • Ho Kun Kim
    • 1
  • Mi Ran Jeong
    • 1
  1. 1.Division of Gastroenterologic Surgery, Department of SurgeryChonnam National University Hwasun HospitalJeollanam-doRepublic of Korea

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