title: [Clavien-Dindo classification and risk factors for complications after radical gastrectomy for gastric cancer].
abstract: OBJECTIVE
  To explore the complications after radical gastrectomy in patients with gastric cancer according to Clavien-Dindo classification and examine the major risk factors for complications.
  
  
  METHODS
  From October 2010 to June 2013, a total of 614 patients undergoing radical gastrectomy at Department of Gastric,Duodenal & Pancreatic Surgery at Hunan Provincial Tumor Hospital were divided into 2 groups according to the occurrence of complications (n = 76, 12.38%) or not (n = 538, 87.62%). Their clinicopathological data, such as age, gender, co-morbidities, surgical duration, operative blood loss volume and pathological stage were retrospectively analyzed by Logistic regression with a case-control model.
  
  
  RESULTS
  Among them, 76 patients developed complications (12.38%). According to Clavien-Dindo classification, 56(9.12%), 14(2.28%), 3(0.49%) and 3(0.49%) patients suffered stage II, III, IV and V complications respectively. Comparing with the control group, the patients had a higher transfusion rate (43.42% (n = 33) vs 24.16% (n = 130), P < 0.01) and a longer postoperative hospital stay in the complication group ((23 ± 18) vs (14 ± 6) days, P < 0.01). There was no difference in age, gender, body mass index (BMI), number of dissected lymph node, levels of hemoglobin and albumin at admission, intraoperative hemorrhage, surgical duration and pathological TNM stage in two groups (all P > 0.05). Univariate analysis revealed that BMI > 25 kg/m(2), co-morbidities, diabetes mellitus, complications due to gastric cancer, hemoglobin <100 g/L, albumin <30 g/L, ascites, total gastrectomy, combined multi-organ resection, surgical duration >240 min and perioperative transfusion were associated with postoperative complications (all P < 0.05).Further multivariate analysis showed that perioperative transfusion (OR = 2.78, 95%CI: 1.42-5.43, P < 0.01) and combined multi-organ resection (OR = 1.72, 95%CI: 1.14-2.58, P = 0.01) were independent risk factors for postoperative complications after radical gastrectomy.
  
  
  CONCLUSIONS
  Classifying the complications after radical gastrectomy according to Clavien-Dindo classification is important for comparisons and quality assessments among different studies. And decreasing perioperative transfusion and avoiding combined multi-organ resection may reduce the incidence of postoperative complications and shorten the length of hospital stay.
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Xiao
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Shu-guang
authors.initials: SG
authors.lastname: Pan
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yin
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Quan
authors.affiliation: Department of Gastric,Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Xiao-xin
authors.initials: XX
authors.lastname: Qiu
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Department of Gastric, Duodenal & Pancreatic Surgery, Affiliated Tumor Hospital, Xiangya Medical School, Central South University, Changsha 410013, China. Email: zuochaohui@vip.sina.com.
authors.forename: Chao-hui
authors.initials: CH
authors.lastname: Zuo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology*; D055815:Young Adult