International consensus on a complications list after gastrectomy for cancer
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.
KeywordsPerioperative complications Gastric cancer Gastrectomy International consensus Clavien–Dindo classification Comprehensive Complications Index
The authors gratefully acknowledge the scientific support of the International Gastric Cancer Association (IGCA) and the Italian Research Group on Gastric Cancer (GIRCG) that have promoted this study. The findings of the project were presented at the 12th International Gastric Cancer Congress in Beijing on April 21, 2017. The authors are grateful to the scientific organizers and participants of the conference for their helpful feedback on this article. The authors also gratefully acknowledge the support of RicerChiAmo onlus (http://www.ricerchiamobrescia.it) for partly funding the implementation of the Complications Recording Sheet through an electronic datasheet application.
Compliance with ethical standards
Human and animal rights statement
This article does not contain any studies with human or animal subjects performed by any of the authors.
Conflict of interest
All authors declare that there are no conflicts of interest.
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