Postoperative delayed emptying after total, subtotal, or distal gastrectomy for gastric cancer: a population-based study

J Gastrointest Surg. 2024 Jul;28(7):1083-1088. doi: 10.1016/j.gassur.2024.04.026. Epub 2024 May 3.

Abstract

Background: This study aimed to examine the rate of delayed emptying and other 90-day postoperative complications after total, subtotal, and distal gastrectomies for gastric adenocarcinoma in a population-based setting.

Methods: This study included all patients who underwent total, subtotal, or distal gastrectomy for gastric cancer in Finland in 2005-2016, with follow-up until December 31, 2019. Logistic regression provided the odds ratios with 95% CIs of 90-day mortality. The results were adjusted for age, sex, year of surgery, comorbidities, pathologic stage, and neoadjuvant therapy.

Results: A total of 2058 patients underwent total (n = 1227), subtotal (n = 450), or distal (n = 381) gastrectomy. In the total, subtotal, and distal gastrectomy groups, the rates of 90-day delayed emptying were 1.7%, 1.3%, and 2.1% in the whole cohort and 1.6%, 1.8%, and 3.5% in the subgroup analysis of R0 resections, respectively. The resection type was not associated with the risk of delayed emptying. Subtotal gastrectomy was associated with a lower risk of major complications and reoperations, whereas distal gastrectomy was associated with a lower risk of anastomotic complications.

Conclusion: The extent of resection did not affect delayed emptying, whereas fewer postoperative complications were observed after subtotal or distal gastrectomy than after total gastrectomy.

Keywords: Delayed conduit emptying; Delayed gastric emptying; Gastrectomy; Gastric adenocarcinoma; Postoperative complication.

MeSH terms

  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / surgery
  • Aged
  • Female
  • Finland / epidemiology
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Gastric Emptying
  • Gastroparesis / epidemiology
  • Gastroparesis / etiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Reoperation / statistics & numerical data
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery