title: Postoperative complications requiring relaparotomies after 700 gastretomies performed for gastric cancer.
abstract: BACKGROUND
  Prevention of fatal postoperative complications and improved management of patients with complications are important means of increased survival in gastric cancer patients.
  
  
  METHODS
  A study of 700 patients undergoing gastrectomy was performed to examine factors that contributed to a high rate of postoperative complications.
  
  
  RESULTS
  Of 700 patients undergoing gastrectomy for adenocarcinoma, 40 (5.7%) underwent reexploration because of serious complications. The frequency of the relaparotomies varied from 2.1% and 4.4% after regular subtotal and total gastrectomies, respectively, to 20% and 30.4% after palliative and conventional total gastrectomies, respectively. The complications that required reexploration most frequently were anastomotic leakage and incompetence of sutures (11, 27.5%), intra-abdominal abscesses (8, 20%), and pancreatic necrosis (7, 17.5%). A combination of preventive measures allowed the attainment of low rates of esophagojejunal anastomotic leakage (0.8%).
  
  
  CONCLUSIONS
  We believe that the decision to perform an urgent reexploration, based on clinical findings, should generally be made by a group of experienced surgeons (not only the primary surgeon). Timely relaparotomy prevented death in 37.5% of the patients with serious acute postoperative complications.
authors.affiliation: Department of Surgery, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: I B
authors.initials: IB
authors.lastname: Shchepotin
authors.forename: S R
authors.initials: SR
authors.lastname: Evans
authors.forename: V A
authors.initials: VA
authors.lastname: Chorny
authors.forename: M
authors.initials: M
authors.lastname: Shabahang
authors.forename: R R
authors.initials: RR
authors.lastname: Buras
authors.forename: R J
authors.initials: RJ
authors.lastname: Nauta
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate