Our Summary

The research paper studies the impact of various pre-surgery risk factors on the outcome of patients who undergo gastrectomy (stomach removal surgery), specifically for AEG II/III tumors and gastric cancer.

Out of 139 patients, 23% had a partial gastrectomy, 59% had a complete gastrectomy, and 18% had an extended gastrectomy. About 36% of the patients had minor complications, while 24% had major complications - which led to a longer stay in the hospital. The death rate during hospital stay was about 2.5%.

The factors that most affected the complications included the age of the patient and the type of surgical procedure - with extended gastrectomy being the riskiest.

Three risk scores (p-POSSUM, Cologne Risk, and NSQIP scores) were found to strongly predict the chances of complications, while the o-POSSUM score was not as accurate.

The research concludes that these risk scores could be used to identify patients who are at high risk, which can aid in planning the treatment approach.

FAQs

  1. What were the most common types of gastrectomy performed in the study and what percentage of patients underwent each type?
  2. What were the major factors that affected post-surgery complications in the studied patients?
  3. How effective were the p-POSSUM, Cologne Risk, and NSQIP scores in predicting the chances of complications after gastrectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient undergoing gastrectomy is to closely follow the post-operative care instructions provided by the medical team. This may include dietary guidelines, medication schedules, and wound care instructions to ensure a smooth recovery and minimize the risk of complications. Additionally, it is important for patients to communicate any concerns or changes in symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended gastrectomy include those with AEG II/III tumors and gastric cancer. Additionally, patients who are younger and undergoing a partial or complete gastrectomy may have a lower risk of complications compared to those undergoing an extended gastrectomy. Patients with higher risk scores (p-POSSUM, Cologne Risk, and NSQIP scores) may benefit from closer monitoring and personalized treatment plans to reduce the chances of complications.

Timeline

Before gastrectomy:

  1. Patient undergoes various tests and evaluations to determine the need for gastrectomy, such as endoscopy, imaging scans, and blood tests.
  2. Patient receives counseling and education about the surgery, including potential risks and benefits.
  3. Patient may need to follow a special diet or take medications to prepare for surgery.
  4. Surgery is performed, which can involve partial, complete, or extended gastrectomy depending on the severity of the condition.

After gastrectomy:

  1. Patient is closely monitored in the hospital for any complications or side effects of the surgery.
  2. Patient may experience pain, discomfort, and difficulty eating in the immediate post-operative period.
  3. Patient undergoes follow-up appointments with the surgical team to monitor healing and recovery.
  4. Patient may need to make dietary and lifestyle changes to adjust to life without a stomach.
  5. Long-term follow-up is required to monitor for any potential complications or recurrence of the condition.

What to Ask Your Doctor

Some questions a patient should ask their doctor about gastrectomy include:

  1. What type of gastrectomy procedure is recommended for my specific condition?
  2. What are the potential risks and complications associated with gastrectomy surgery?
  3. How will my recovery process look like after the surgery?
  4. What are the chances of experiencing complications during or after the surgery?
  5. How will my diet and lifestyle need to be adjusted after gastrectomy?
  6. Are there any alternative treatment options to gastrectomy that I should consider?
  7. How experienced is the surgical team in performing gastrectomy procedures?
  8. What pre-surgery tests or evaluations will be necessary before undergoing gastrectomy?
  9. How will my quality of life be impacted after gastrectomy surgery?
  10. Are there any specific risk factors or health conditions that could increase my chances of complications during gastrectomy?

Reference

Authors: Eichelmann AK, Saidi M, Lindner K, Lenschow C, Palmes D, Pascher A, Hummel R. Journal: World J Surg Oncol. 2020 Jan 24;18(1):17. doi: 10.1186/s12957-020-1790-6. PMID: 31980026