title: [Risk factors associated with postoperative complications of D2 radical resection for local advanced gastric cancer].
abstract: OBJECTIVE
  To evaluate the risk factors of postoperative complications following D2 radical resection for advanced gastric cancer.
  
  
  METHODS
  From June 2004 to May 2011, 483 patients with local advanced gastric cancer who underwent radical gastrectomy with D2 lymph node dissection were enrolled in the study, including 132 patients of LAG (27.3%) and 351 patients of open procedure (72.7%). Clinicopathological data and postoperative complications were reviewed retrospectively. Postoperative complications were classified into overall and severe complications according to Clavien-Dindo Classification. Multivariate logistic model was used to identify risk factors of postoperative complications.
  
  
  RESULTS
  The overall incidence of postoperative overall and severe complications and mortality were 12.4% (60/483), 2.5% (12/483) and 0.2% (1/483), respectively. Univariate analysis showed that no significant differences were found in overall and severe complications between the two surgical approaches (13.6% vs. 12.0%, P=0.620; 3.0% vs. 2.3%, P=0.743). Furthermore, multivariate analysis showed that age ≥60 years, preoperative comorbidity and intraoperative blood loss >300 ml were independent risk factors associated with overall postoperative complications. Remarkably, intraoperative blood loss >300 ml was also an independent risk factor for severe postoperative complications.
  
  
  CONCLUSIONS
  LAG with D2 lymph node dissection for local advanced gastric cancer is technically feasible and safe. However, the elderly, preoperative comorbidity and increased intraoperative blood loss are associated with elevated risk of complications. Decreased intraoperative bleeding may reduce the potential postoperative complications.
authors: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. gzliguoxin@163.com.
authors: Xiao-liang
authors: XL
authors: Lan
authors: Guo-xin
authors: GX
authors: Li
authors: Hao
authors: H
authors: Liu
authors: Yan-feng
authors: YF
authors: Hu
authors: Hai-jun
authors: HJ
authors: Deng
authors: Ting-yu
authors: TY
authors: Mou
mesh_terms: D005260:Female; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D016015:Logistic Models; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*