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Preoperative C ‐reactive protein and operative blood loss predict poor prognosis in patients with gastric cancer after laparoscopy‐assisted gastrectomy
Author(s) -
Ishino Yoshito,
Saigusa Susumu,
Ohi Masaki,
Yasuda Hiromi,
Tanaka Koji,
Toiyama Yuji,
Mohri Yasuhiko,
Kusunoki Masato
Publication year - 2014
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12126
Subject(s) - medicine , gastrectomy , perioperative , blood loss , laparoscopy , weight loss , cancer , surgery , gastroenterology , body weight , retrospective cohort study , body mass index , multivariate analysis , anastomosis , obesity
The aim of this study was to clarify the factors associated with postoperative complications and prognoses following laparoscopy‐assisted gastrectomy for gastric cancer. Methods A total of 214 patients who underwent laparoscopy‐assisted gastrectomy for gastric cancer were enrolled in this retrospective study. Factors that were potentially associated with postoperative complications and prognosis were assessed using the following clinical and perioperative parameters: the E stimation of P hysiologic A bility and S urgical S tress scoring system, the P rognostic N utritional I ndex, and the C lavien– D indo classification. Results Postoperative complications developed in 18.7% of patients. Blood loss ≥ 1% of body weight was significantly correlated with anastomotic leakage ( P = 0.0108). Severe complications, based on the C lavien– D indo classification, were more frequent in patients with proximal or total gastrectomies ( P = 0.0324). A preoperative C ‐reactive protein level > 0.5 mg/dL, blood loss > 1% of body weight, age ≥ 70 years at the time of operation, and an E stimation of P hysiologic A bility and S urgical S tress score ≥ 0.2 were significantly correlated with poor prognosis. Multivariate analysis revealed that two of these factors, preoperative C ‐reactive protein level ≥ 0.5 mg/dL and operative blood loss ≥ 1% of body weight, were independent prognostic factors ( P = 0.0376 and P = 0.0112, respectively). The P rognostic N utritional I ndex had no significant correlation with prognosis or the occurrence of postoperative complications. Conclusion Operative blood loss ≥ 1% of body weight and type of resection were associated with an increased frequency of postoperative complications, while preoperative C ‐reactive protein levels and operative blood loss may be prognostic predictors for gastric cancer patients following laparoscopy‐assisted gastrectomy.