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Observational Study
. 2024 Sep;76(5):1855-1864.
doi: 10.1007/s13304-023-01739-6. Epub 2024 Feb 15.

Clinical predictors of postoperative complications in the context of enhanced recovery (ERAS) in patients with esophageal and gastric cancer

Christian Geroin  1 , Jacopo Weindelmayer  2 , Serena Camozzi  2 , Barbara Leone  2 , Cecilia Turolo  2 , Selma Hetoja  2 , Maria Bencivenga  2 , Michele Sacco  2 , Carlo Alberto De Pasqual  2 , Eugenia Mattioni  2 , Giovanni de Manzoni  2 , Simone Giacopuzzi  3
Affiliations
Observational Study

Clinical predictors of postoperative complications in the context of enhanced recovery (ERAS) in patients with esophageal and gastric cancer

Christian Geroin et al. Updates Surg. 2024 Sep.

Abstract

The overall frequency of postoperative complications in patients with esophageal and gastric cancer diverges between studies. We evaluated the frequency and assessed the relationship between complications and demographic and clinical features. For this observational study, data were extracted from the ERAS Registry managed by the University of Verona, Italy. Patients were evaluated and compared for postoperative complications according to the consensus-based classification and the Clavien-Dindo scale. The study population was 877 patients: 346 (39.5%) with esophageal and 531 (60.5%) with gastric cancer; 492 (56.2%) reported one or more postoperative complications, 213 (61.6%) of those with esophageal and 279 (52.5%) of those with gastric cancer. When stratified by consensus-based classification, patients with esophageal cancer reported general postoperative complications more frequently (p < 0.001) than those with gastric cancer, but there was no difference in postoperative surgical complications between the two groups. Multiple logistic regression models revealed an association between postoperative complications and the Charlson Comorbidity Index (adjusted odds ratio [OR] 1.22; 95% confidence interval [CI] 1.08-1.36), operation time (adjusted OR, 1.08; 95% CI 1.00-1.15), and days to solid diet intake (adjusted OR, 1.39; 95% CI 1.20-1.59). Complications in patients with esophageal and gastric cancer are frequent, even in those treated according to ERAS principles, and are often associated with comorbidities, longer operative time, and longer time to solid diet intake.

Keywords: Enhanced recovery after surgery; Gastric and esophageal cancer; Postoperative complications; Prehabilitation; Surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Compliance with ERAS items (n = 15) for esophageal (panel A) and gastric (panel B) cancer; POD denotes postoperative days
Fig. 2
Fig. 2
Panel A Comparison of complications in patients treated for esophageal or gastric cancer according to a consensus-based classification; panel B percentage of postoperative general and surgical complications. The category “minor/other” includes complications that cannot be classified within the consensus-based classification. Abbreviations: CPR cardiopulmonary resuscitation, CCU coronary care unit, ICU intensive care unit, EF ejection fraction, CVVH continuous veno-venous hemofiltration, NG nasogastric
See this image and copyright information in PMC

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