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LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER

BACKGROUND: Laparoscopic surgery has been gradually accepted as an option for the surgical treatment ofgastric cancer. There are still points that are controversial or situations that are eventually associated with intra-operative difficulties or postoperative complications. AIM: To establish the re...

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Autores principales: BRAGHETTO, Italo, LANZARINI, Enrique, MUSLEH, Maher, GUTIÉRREZ, Luis, MOLINA, Juan Carlos, KORN, Owen, FIGUEROA, Manuel, LASNIBAT, Juan Pablo, ORELLANA, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Colégio Brasileiro de Cirurgia Digestiva 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747491/
https://www.ncbi.nlm.nih.gov/pubmed/33331434
http://dx.doi.org/10.1590/0102-672020200003e1539
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author BRAGHETTO, Italo
LANZARINI, Enrique
MUSLEH, Maher
GUTIÉRREZ, Luis
MOLINA, Juan Carlos
KORN, Owen
FIGUEROA, Manuel
LASNIBAT, Juan Pablo
ORELLANA, Omar
author_facet BRAGHETTO, Italo
LANZARINI, Enrique
MUSLEH, Maher
GUTIÉRREZ, Luis
MOLINA, Juan Carlos
KORN, Owen
FIGUEROA, Manuel
LASNIBAT, Juan Pablo
ORELLANA, Omar
author_sort BRAGHETTO, Italo
collection PubMed
description BACKGROUND: Laparoscopic surgery has been gradually accepted as an option for the surgical treatment ofgastric cancer. There are still points that are controversial or situations that are eventually associated with intra-operative difficulties or postoperative complications. AIM: To establish the relationship between the difficulties during the execution of total gastrectomy and the occurrence of eventual postoperative complications. METHOD: The operative protocols and postoperative evolution of 74 patients operated for gastriccancer, who were subjected to laparoscopic total gastrectomy (inclusion criteria) were reviewed. The intraoperative difficulties recorded in the operative protocol and postoperative complications of a surgical nature wereanalyzed (inclusion criteria). Postoperative medical complications were excluded (exclusion criteria). For the discussion, an extensive bibliographical review was carried out. RESULTS: Intra-operative difficulties or complications reported correspond to 33/74 and of these; 18 events (54.5%) were related to postoperative complications and six were absolutely unexpected. The more frequent were leaks of the anastomosis and leaks of the duodenal stump; however, other rare complications were observed. Seven were managed with conservative measures and 17 (22.9%) required surgical re-exploration, with a postoperative mortality of two patients (2.7%). CONCLUSION: We have learned that there are infrequent and unexpected complications; the treating team must be mindful of and, in front of suspicion of complications, anappropriate decision must be done which includes early re-exploration. Finally, after the experience reported, some complications should be avoided.
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spelling pubmed-77474912021-01-04 LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER BRAGHETTO, Italo LANZARINI, Enrique MUSLEH, Maher GUTIÉRREZ, Luis MOLINA, Juan Carlos KORN, Owen FIGUEROA, Manuel LASNIBAT, Juan Pablo ORELLANA, Omar Arq Bras Cir Dig Original Article BACKGROUND: Laparoscopic surgery has been gradually accepted as an option for the surgical treatment ofgastric cancer. There are still points that are controversial or situations that are eventually associated with intra-operative difficulties or postoperative complications. AIM: To establish the relationship between the difficulties during the execution of total gastrectomy and the occurrence of eventual postoperative complications. METHOD: The operative protocols and postoperative evolution of 74 patients operated for gastriccancer, who were subjected to laparoscopic total gastrectomy (inclusion criteria) were reviewed. The intraoperative difficulties recorded in the operative protocol and postoperative complications of a surgical nature wereanalyzed (inclusion criteria). Postoperative medical complications were excluded (exclusion criteria). For the discussion, an extensive bibliographical review was carried out. RESULTS: Intra-operative difficulties or complications reported correspond to 33/74 and of these; 18 events (54.5%) were related to postoperative complications and six were absolutely unexpected. The more frequent were leaks of the anastomosis and leaks of the duodenal stump; however, other rare complications were observed. Seven were managed with conservative measures and 17 (22.9%) required surgical re-exploration, with a postoperative mortality of two patients (2.7%). CONCLUSION: We have learned that there are infrequent and unexpected complications; the treating team must be mindful of and, in front of suspicion of complications, anappropriate decision must be done which includes early re-exploration. Finally, after the experience reported, some complications should be avoided. Colégio Brasileiro de Cirurgia Digestiva 2020-12-18 /pmc/articles/PMC7747491/ /pubmed/33331434 http://dx.doi.org/10.1590/0102-672020200003e1539 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
BRAGHETTO, Italo
LANZARINI, Enrique
MUSLEH, Maher
GUTIÉRREZ, Luis
MOLINA, Juan Carlos
KORN, Owen
FIGUEROA, Manuel
LASNIBAT, Juan Pablo
ORELLANA, Omar
LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title_full LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title_fullStr LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title_full_unstemmed LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title_short LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER
title_sort lessons learned analyzing complications after laparoscopic total gastrectomy for gastric cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747491/
https://www.ncbi.nlm.nih.gov/pubmed/33331434
http://dx.doi.org/10.1590/0102-672020200003e1539
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