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Does epidural analgesia modify the risk of complications after gastrectomy?
, 1, 2, 13, 1, 4, 1
Affiliations- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- City Hospital Czerniakowski, Warsaw, Poland
- Medical Centre for Postgraduate Education, Warsaw, Poland
- County Health Center, Otwock, Poland
open access
Abstract
Introduction. The surgical treatment of Gastric Cancer is associated with overall complication rates as high as 50%. The intent of this study was to assess the impact of epidural analgesia (EA) on postoperative complication rates among patients undergoing gastric resections.
Materials and methods. Of the 617 gastric cancer patients who between 2002 and 2010 had undergone stomach resection, 246 (39.8%) were administered EA. Groups with and without EA were compared.
Results. The general rate of complications was lower in the EA group in the univariable analysis – 38.5% vs. 54.2% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.34–0.66, p < 0.001), intra-abdominal abscess (OR 0,28, 95% CI: 0.14–0.59, p = 0.001), pneumonia (OR 0,39, 95% CI: 0.24–0.63, p < 0.001), temperature > 38°C (OR 0.53, 95% CI: 0.37–0.74, p < 0.001) and re-operation (OR 0.53, 95% CI: 0.28–1.00, p = 0.049). These relationships were confirmed in a multivariable analysis for the general number of complications (OR 0.53, 95% CI: 0.37–0.75, p < 0.001), intra-abdominal abscess (OR 0.36, 95% CI: 0.16–0.77, p = 0.009), temperature > 38°C (OR 0.56, 95% CI: 0.39–0.82, p = 0.009), pneumonia (OR 0.42, 95% CI: 0.25–0.71, p = 0.001).
Conclusions. Our findings indicate that postoperative treatment with EA for patients undergoing stomach resection is safe and contributes to a reduction in the number of postoperative complications.
Abstract
Introduction. The surgical treatment of Gastric Cancer is associated with overall complication rates as high as 50%. The intent of this study was to assess the impact of epidural analgesia (EA) on postoperative complication rates among patients undergoing gastric resections.
Materials and methods. Of the 617 gastric cancer patients who between 2002 and 2010 had undergone stomach resection, 246 (39.8%) were administered EA. Groups with and without EA were compared.
Results. The general rate of complications was lower in the EA group in the univariable analysis – 38.5% vs. 54.2% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.34–0.66, p < 0.001), intra-abdominal abscess (OR 0,28, 95% CI: 0.14–0.59, p = 0.001), pneumonia (OR 0,39, 95% CI: 0.24–0.63, p < 0.001), temperature > 38°C (OR 0.53, 95% CI: 0.37–0.74, p < 0.001) and re-operation (OR 0.53, 95% CI: 0.28–1.00, p = 0.049). These relationships were confirmed in a multivariable analysis for the general number of complications (OR 0.53, 95% CI: 0.37–0.75, p < 0.001), intra-abdominal abscess (OR 0.36, 95% CI: 0.16–0.77, p = 0.009), temperature > 38°C (OR 0.56, 95% CI: 0.39–0.82, p = 0.009), pneumonia (OR 0.42, 95% CI: 0.25–0.71, p = 0.001).
Conclusions. Our findings indicate that postoperative treatment with EA for patients undergoing stomach resection is safe and contributes to a reduction in the number of postoperative complications.
Keywords
gastric cancer; GEJ cancer; epidural analgesia; postoperative complications; gastrectomy; postoperative pain
About this articleTitle
Does epidural analgesia modify the risk of complications after gastrectomy?
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Research paper (original)
Pages
202-211
Published online
2021-06-09
Page views
514
Article views/downloads
402
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2021;71(4):202-211.
Keywords
gastric cancer
GEJ cancer
epidural analgesia
postoperative complications
gastrectomy
postoperative pain
Authors
Tomasz Olesiński
Marta Urbańska
Anna Borkowska
Paulina Wieszczy
Dariusz Król
Dorota Rucz
Małgorzata Symonides
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