Introduction

E. Strong (ed.). Gastric cancer. Principles and practice. Springer (2015)


Gastric surgery is complex and is associated with high rates of morbidity, mortality, and hospital readmission. Complications can be divided into early (most often defined as within 30 days of surgery) and late. The majority of early complications after gastric surgery include common surgical morbidities such as anastomotic leakage, wound infections, abscess, bowel obstruction, and the risks of general surgery, such as cardiovascular events, respiratory complications, and venous thrombosis. Postoperative complications can lead to readmission, which is of concern because of the proposed reductions in payments by the Centers for Medicare and Medicaid Services to hospitals with high readmission rates. Readmission rates after gastrectomy are significant, ranging from 10 to 20% within 30 days of surgery. Late complications include not only delayed presentation of early complications but also unique complications of gastrectomy, including the so-called postgastrectomy syndromes.

Postgastrectomy syndromes include bile reflux gastritis, dumping syndrome, afferent and efferent limb syndrome, Roux stasis syndrome, and postvagotomy diarrhea. This chapter discusses overall morbidity and mortality rates of patients who have undergone resection for gastric cancer and will describe early and late complications of gastric surgery, with a focus on diagnosis, medical management, and surgical treatment.

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