International consensus on a complications list after gastrectomy for cancer.

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

Journal

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
ISSN: 1436-3305
Titre abrégé: Gastric Cancer
Pays: Japan
ID NLM: 100886238

Informations de publication

Date de publication:
01 2019
Historique:
received: 15 05 2018
accepted: 19 05 2018
pubmed: 31 5 2018
medline: 16 4 2019
entrez: 31 5 2018
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 29846827
doi: 10.1007/s10120-018-0839-5
pii: 10.1007/s10120-018-0839-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

172-189

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Auteurs

Gian Luca Baiocchi (GL)

Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy. gianluca.baiocchi@unibs.it.
3rd Division of General Surgery, Spedali Civili di Brescia, P.le Spedali Civili 1, 25127, Brescia, Italy. gianluca.baiocchi@unibs.it.

Simone Giacopuzzi (S)

Department of Surgery, General and Upper G.I. Surgery Division, University of Verona, Verona, Italy.

Daniele Marrelli (D)

Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.

Daniel Reim (D)

Surgical Department, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.

Guillaume Piessen (G)

Department of Digestive and Oncological Surgery, Univ. Lille, and Claude Huriez University Hospital, Lille, France.

Paulo Matos da Costa (P)

Faculdade Medicina, Universidade Lisboa, Lisbon, Portugal.
General Surgery Department, Hospital Garcia de Orta, Lisbon, Portugal.

John V Reynolds (JV)

Department of Surgery, St. James's Hospital and Trinity College Dublin, Dublin, Ireland.

Hans-Joachim Meyer (HJ)

Generalsekretär, Deutsche Gesellschaft für Chirurgie, Berlin, Germany.

Paolo Morgagni (P)

GB Morgagni-L Pierantoni Surgical Department, Forlì, Italy.

Ines Gockel (I)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.

Lucio Lara Santos (L)

Experimental Pathology and Therapeutics Group and Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal.

Lone Susanne Jensen (LS)

Department of Surgery, Aarhus University Hospital, Aarhus C, Denmark.

Thomas Murphy (T)

Department of Surgery, Mercy University Hospital, Cork City, Ireland.

Shaun R Preston (SR)

Oesophageal Gastric Unit, Royal Surrey County Hospital NHS Foundation Trust, Guilford, UK.

Mikhail Ter-Ovanesov (M)

Oncological and Haematological RUPF, Moscow Municipal Oncological Hospital, Moscow, Russia.

Uberto Fumagalli Romario (U)

2nd Division of General Surgery, Spedali Civili, Brescia, Italy.

Maurizio Degiuli (M)

Department of Oncology, Head, Digestive and Surgical Oncology, University of Torino, and San Luigi University Hospital, Orbassano, Italy.

Wojciech Kielan (W)

2nd Department of General and Oncological Surgery, Wroclaw Medical University, Wrocław, Poland.

Stefan Mönig (S)

Division of Abdominal Surgery, University Hospital of Geneva, Geneva, Switzerland.

Piotr Kołodziejczyk (P)

Department of Surgery I, Jagiellonian University, Krakow, Poland.

Wojciech Polkowski (W)

Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland.

Richard Hardwick (R)

Spire Cambridge Lea Hospital, Cambridge, UK.

Manuel Pera (M)

Department of Surgery, Section of Gastrointestinal Surgery, Hospital Universitario del Mar, Universitat Autònoma de Barcelona, and Hospital Universitario del Mar Medical Research Institute (IMIM), Barcelona, Spain.

Jan Johansson (J)

Department of Clinical Sciences, Surgery, Faculty of Medicine, Lund University, Lund, Sweden.

Paul M Schneider (PM)

Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland.

Wobbe O de Steur (WO)

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Suzanne S Gisbertz (SS)

Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.

Henk Hartgrink (H)

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Joanna W van Sandick (JW)

Department of Surgery, Netherlands Cancer Institute, and Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Nazario Portolani (N)

Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy.
3rd Division of General Surgery, Spedali Civili di Brescia, P.le Spedali Civili 1, 25127, Brescia, Italy.

Arnulf H Hölscher (AH)

German Center for Esophageal and Gastric Surgery, Agaplesion Markuskrankenhaus, Frankfurt, Germany.

Maristella Botticini (M)

IGIER, Università Bocconi, Milan, Italy.

Franco Roviello (F)

Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.

Christophe Mariette (C)

Department of Digestive and Oncological Surgery, Univ. Lille, and Claude Huriez University Hospital, Lille, France.

William Allum (W)

Department of Surgery, Royal Marsden NHS Foundation Trust, London, UK.

Giovanni De Manzoni (G)

Department of Surgery, General and Upper G.I. Surgery Division, University of Verona, Verona, Italy.

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