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Effects of the preoperative use and dosage of steroids on postoperative complications of gastric cancer surgery

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Abstract

Purpose

To investigate the effects of preoperative steroid administration, including dosage, on complications after gastrectomy for gastric cancer.

Methods

We reviewed patients who underwent gastrectomy for gastric and esophagogastric junctional adenocarcinoma between 2013 and 2019 at the Department of Gastrointestinal Surgery, The University of Tokyo.

Results

Among the total 764 patients eligible for inclusion in the study, 17 were on steroid medication preoperatively (SD group) and 747 were not (ND group). The hemoglobin, serum albumin levels, and respiratory functions were significantly lower in the SD group than in the ND group. The incidence of postoperative complications classified as Clavien–Dindo (C–D) ≥ 2 was significantly greater in the SD group than in the ND group (64.7% vs. 25.6%, p < 0.001). Intra-abdominal infection (35.2% vs. 9.6%, p < 0.001) and anastomotic leakage (11.8% vs. 2.1%, p < 0.001) occurred more frequently in the SD group than in the ND group. On multiple logistic regression analysis for C-D ≥ 3 postoperative complications, the odds ratio for oral steroid use ≥ 5 mg per day as prednisolone had the highest value, of 13.0 (95% confidence interval 2.46–76.2, p < 0.01).

Conclusion

Preoperative oral steroid use was identified as an independent risk factor for postoperative complications after gastrectomy for gastric cancer. Furthermore, the complication rate appears to increase as the oral steroid dosage is increased.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Motonari Ri, Tomonori Narita, Masayuki Urabe, Shuntaro Yoshimura, Shoh Yajima, Yasuhiro Okumura, Koichi Yagi & Yasuyuki Seto

Authors
  1. Motonari Ri
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  2. Tomonori Narita
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  3. Masayuki Urabe
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  4. Shuntaro Yoshimura
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  5. Shoh Yajima
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  6. Yasuhiro Okumura
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  7. Koichi Yagi
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  8. Yasuyuki Seto
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Correspondence to Motonari Ri.

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We declare no conflicts of interest for this article.

Ethical approval

The protocol for this research project was approved by the Ethics Committee of the University of Tokyo and it conforms to the provisions of the Declaration of Helsinki (Approval No. 3962). Informed consent was obtained from the subjects.

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Ri, M., Narita, T., Urabe, M. et al. Effects of the preoperative use and dosage of steroids on postoperative complications of gastric cancer surgery. Surg Today 53, 1173–1180 (2023). https://doi.org/10.1007/s00595-023-02698-6

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  • DOI: https://doi.org/10.1007/s00595-023-02698-6

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