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Gastric Cancer

, Volume 22, Issue 1, pp 172–189 | Cite as

International consensus on a complications list after gastrectomy for cancer

  • Gian Luca Baiocchi
  • Simone Giacopuzzi
  • Daniele Marrelli
  • Daniel Reim
  • Guillaume Piessen
  • Paulo Matos da Costa
  • John V. Reynolds
  • Hans-Joachim Meyer
  • Paolo Morgagni
  • Ines Gockel
  • Lucio Lara Santos
  • Lone Susanne Jensen
  • Thomas Murphy
  • Shaun R. Preston
  • Mikhail Ter-Ovanesov
  • Uberto Fumagalli Romario
  • Maurizio Degiuli
  • Wojciech Kielan
  • Stefan Mönig
  • Piotr Kołodziejczyk
  • Wojciech Polkowski
  • Richard Hardwick
  • Manuel Pera
  • Jan Johansson
  • Paul M. Schneider
  • Wobbe O. de Steur
  • Suzanne S. Gisbertz
  • Henk Hartgrink
  • Joanna W. van Sandick
  • Nazario Portolani
  • Arnulf H. Hölscher
  • Maristella Botticini
  • Franco Roviello
  • Christophe Mariette
  • William Allum
  • Giovanni De Manzoni
Original Article

Abstract

Background

Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus.

Methods

The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications.

Results

A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet.

Conclusion

The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.

Keywords

Perioperative complications Gastric cancer Gastrectomy International consensus Clavien–Dindo classification Comprehensive Complications Index 

Notes

Acknowledgements

The authors gratefully acknowledge the scientific support of the International Gastric Cancer Association (IGCA) and the Italian Research Group on Gastric Cancer (GIRCG) that have promoted this study. The findings of the project were presented at the 12th International Gastric Cancer Congress in Beijing on April 21, 2017. The authors are grateful to the scientific organizers and participants of the conference for their helpful feedback on this article. The authors also gratefully acknowledge the support of RicerChiAmo onlus (http://www.ricerchiamobrescia.it) for partly funding the implementation of the Complications Recording Sheet through an electronic datasheet application.

Compliance with ethical standards

Human and animal rights statement

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of interest

All authors declare that there are no conflicts of interest.

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  • Gian Luca Baiocchi
    • 1
    • 2
  • Simone Giacopuzzi
    • 3
  • Daniele Marrelli
    • 4
  • Daniel Reim
    • 5
  • Guillaume Piessen
    • 6
  • Paulo Matos da Costa
    • 7
    • 8
  • John V. Reynolds
    • 9
  • Hans-Joachim Meyer
    • 10
  • Paolo Morgagni
    • 11
  • Ines Gockel
    • 12
  • Lucio Lara Santos
    • 13
  • Lone Susanne Jensen
    • 14
  • Thomas Murphy
    • 15
  • Shaun R. Preston
    • 16
  • Mikhail Ter-Ovanesov
    • 17
  • Uberto Fumagalli Romario
    • 18
  • Maurizio Degiuli
    • 19
  • Wojciech Kielan
    • 20
  • Stefan Mönig
    • 21
  • Piotr Kołodziejczyk
    • 22
  • Wojciech Polkowski
    • 23
  • Richard Hardwick
    • 24
  • Manuel Pera
    • 25
  • Jan Johansson
    • 26
  • Paul M. Schneider
    • 27
  • Wobbe O. de Steur
    • 28
  • Suzanne S. Gisbertz
    • 29
  • Henk Hartgrink
    • 28
  • Joanna W. van Sandick
    • 30
  • Nazario Portolani
    • 1
    • 2
  • Arnulf H. Hölscher
    • 31
  • Maristella Botticini
    • 32
  • Franco Roviello
    • 4
  • Christophe Mariette
    • 6
  • William Allum
    • 33
  • Giovanni De Manzoni
    • 3
  1. 1.Department of Clinical and Experimental Sciences, Surgical ClinicUniversity of BresciaBresciaItaly
  2. 2.3rd Division of General SurgerySpedali Civili di BresciaBresciaItaly
  3. 3.Department of Surgery, General and Upper G.I. Surgery DivisionUniversity of VeronaVeronaItaly
  4. 4.Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical OncologyUniversity of SienaSienaItaly
  5. 5.Surgical Department, Klinikum Rechts der IsarTechnical University MunichMunichGermany
  6. 6.Department of Digestive and Oncological SurgeryUniv. Lille, and Claude Huriez University HospitalLilleFrance
  7. 7.Faculdade MedicinaUniversidade LisboaLisbonPortugal
  8. 8.General Surgery DepartmentHospital Garcia de OrtaLisbonPortugal
  9. 9.Department of SurgerySt. James’s Hospital and Trinity College DublinDublinIreland
  10. 10.Generalsekretär, Deutsche Gesellschaft für ChirurgieBerlinGermany
  11. 11.GB Morgagni-L Pierantoni Surgical DepartmentForlìItaly
  12. 12.Department of Visceral, Transplant, Thoracic and Vascular SurgeryUniversity Hospital of LeipzigLeipzigGermany
  13. 13.Experimental Pathology and Therapeutics Group and Surgical Oncology DepartmentPortuguese Institute of OncologyPortoPortugal
  14. 14.Department of SurgeryAarhus University HospitalAarhus CDenmark
  15. 15.Department of SurgeryMercy University HospitalCork CityIreland
  16. 16.Oesophageal Gastric UnitRoyal Surrey County Hospital NHS Foundation TrustGuilfordUK
  17. 17.Oncological and Haematological RUPF, Moscow Municipal Oncological HospitalMoscowRussia
  18. 18.2nd Division of General SurgerySpedali CiviliBresciaItaly
  19. 19.Department of Oncology, Head, Digestive and Surgical OncologyUniversity of Torino, and San Luigi University HospitalOrbassanoItaly
  20. 20.2nd Department of General and Oncological SurgeryWroclaw Medical UniversityWrocławPoland
  21. 21.Division of Abdominal SurgeryUniversity Hospital of GenevaGenevaSwitzerland
  22. 22.Department of Surgery IJagiellonian UniversityKrakowPoland
  23. 23.Department of Surgical OncologyMedical University of LublinLublinPoland
  24. 24.Spire Cambridge Lea HospitalCambridgeUK
  25. 25.Department of Surgery, Section of Gastrointestinal SurgeryHospital Universitario del Mar, Universitat Autònoma de Barcelona, and Hospital Universitario del Mar Medical Research Institute (IMIM)BarcelonaSpain
  26. 26.Department of Clinical Sciences, Surgery, Faculty of MedicineLund UniversityLundSweden
  27. 27.Center for Visceral, Thoracic and Specialized Tumor SurgeryHirslanden Medical CenterZurichSwitzerland
  28. 28.Department of SurgeryLeiden University Medical CenterLeidenThe Netherlands
  29. 29.Department of SurgeryAcademic Medical CenterAmsterdamThe Netherlands
  30. 30.Department of SurgeryNetherlands Cancer Institute, and Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  31. 31.German Center for Esophageal and Gastric Surgery, Agaplesion MarkuskrankenhausFrankfurtGermany
  32. 32.IGIERUniversità BocconiMilanItaly
  33. 33.Department of SurgeryRoyal Marsden NHS Foundation TrustLondonUK

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