This study elucidated risk factors and management for intra-abdominal infection after extended radical gastrectomy.
From 1988 to 2004, 2,076 patients with gastric cancer underwent extended radical gastrectomy at Taipei Veterans General Hospital. Risk factors for intra-abdominal infection were determined by analyzing clinicopathological factors, operative procedure, combined organ resection, operative time, blood loss, and associated disease(s). Management modalities were summarized.
The overall complication rate was 18.7%. Eighty (3.9%) patients were found to have intra-abdominal infections. Age, prolonged operation time, and combined organ resection were the precipitating factors.
These patients were categorized into 3 groups: intra-abdominal abscess with adequate drainage, intra-abdominal abscess without anastomotic leakage, and intra-abdominal abscess because of leakage.
Adequate drainage was the primary treatment.
Mortality rate was 22.5% (18), and the most common cause of mortality was intra-abdominal abscess caused by leakage.
Although expert surgical skills can minimize the incidence of intra-abdominal infection, management also requires experience and training.
American Journal of Surgery
Division of General Surgery, Taipei Veterans General Hospital and National Yang Ming University, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
Am J Surg. 2008 Nov;196(5):741-5
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