Complications After Gastrectomy for Cancer

In Western countries, perioperative complications severely affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates. In 2015 the European project “Complications after gastrectomy for cancer” was launched. The first step was the setup of a standardized list of 27 complications, with clinical definitions. The second step was the retrospective collection of consecutive gastrectomies performed in 2017–2018 at participating European centers, including clinical, oncological and surgical data, and outcome measures at hospital discharge, 30 and 90 days postoperatively. Eventually, data on 1349 gastrectomies were entered into an international database and then analyzed. The overall incidence of complications was 29.8%. The most frequent complications were non-surgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%). In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively. Actions are therefore needed to limit the incidence and to effectively treat the most frequent and most lethal complications.