| Title |
Risk factors affecting unplanned reoperation after laparoscopic gastrectomy for gastric cancer: experience from a high-volume center
|
|---|---|
| Published in |
Surgical Endoscopy, February 2017
|
| DOI | 10.1007/s00464-017-5423-2 |
| Pubmed ID | |
| Authors |
Ping Li, Chang-Ming Huang, Ru-Hong Tu, Jian-Xian Lin, Jun Lu, Chao-Hui Zheng, Jian-Wei Xie, Jia-Bin Wang, Qi-Yue Chen, Long-Long Cao, Mi Lin |
| Abstract |
To evaluate the risk factors affecting unplanned reoperation (URO) after laparoscopic gastrectomy (LAG) for gastric cancer (GC) and establish a model to predict URO preoperatively. Between May 2007 and December 2014, we prospectively collected and retrospectively analyzed the data of 2608 GC patients who underwent LAG. Among them, 2580 patients not requiring an URO were defined as the Non-URO group, and 28 patients requiring an URO were defined as the URO group. Univariate, multivariate, and bootstrap analyses were performed to determine the independent predictors for URO, and a nomogram was constructed to preoperatively predict the rate of URO after LAG. Of the 2608 patients, the URO rate was 1.1% (28/2608) within the 30-day hospitalization. The mean URO time interval to first operation was 5.6 ± 5.5 (0.10-18.5) days. The main causes requiring URO were intraabdominal bleeding (57.1%), anastomotic bleeding (17.9%), anastomotic leakage (7.1%), and intraabdominal infection (7.1%). Compared to the Non-URO group, the URO group had a significantly longer hospital stay (p < 0.001) and significantly higher hospital fees (p < 0.001). The morbidity rate was 39.2% in the URO group and 14.5% in the non-URO group (p = 0.001), and mortality was 3.6% in the URO group and 0.2% in the non-URO group (p = 0.063). Multivariate analysis using bootstrap method revealed that age >70 years (odds ratio (OR) = 2.232, 95% confidence interval (CI) = 1.023-4.491, p = 0.028), male gender (OR = 32.983, 95% CI 1.405-25.343 × 10(6), p = 0.027), and body mass index (BMI) > 25 kg/m(2) (OR = 2.550, 95% CI 1.017-5.398, p = 0.012) were independent risk factors for URO. A multivariable nomogram model for predicting URO exhibited a strong optimism-adjusted discrimination (concordance index, 0.687). No significant correlation was noted between the URO rate and operative period by Spearman analysis (r = 0.012, p = 0.548). Age > 70 years, Male, and BMI > 25 kg/m(2) were independent risk factors for URO. Based on the three risk factors, we developed a simple and practical nomogram to predict URO preoperatively, which might aid surgeons in reducing the URO rate when planning to perform LAG for GC. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 20% |
| Colombia | 1 | 20% |
| Spain | 1 | 20% |
| Unknown | 2 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 40% |
| Practitioners (doctors, other healthcare professionals) | 2 | 40% |
| Science communicators (journalists, bloggers, editors) | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 17% |
| Student > Master | 3 | 13% |
| Student > Doctoral Student | 2 | 8% |
| Lecturer | 1 | 4% |
| Librarian | 1 | 4% |
| Other | 5 | 21% |
| Unknown | 8 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 38% |
| Unspecified | 2 | 8% |
| Veterinary Science and Veterinary Medicine | 1 | 4% |
| Nursing and Health Professions | 1 | 4% |
| Mathematics | 1 | 4% |
| Other | 2 | 8% |
| Unknown | 8 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 October 2017.
All research outputs
#13,900,658
of 23,577,761 outputs
Outputs from Surgical Endoscopy
#2,929
of 6,259 outputs
Outputs of similar age
#231,687
of 457,438 outputs
Outputs of similar age from Surgical Endoscopy
#36
of 85 outputs
Altmetric has tracked 23,577,761 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,259 research outputs from this source. They receive a mean Attention Score of 4.1. This one has gotten more attention than average, scoring higher than 51% of its peers.
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We're also able to compare this research output to 85 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.