International consensus on a complications list after gastrectomy for cancer

Gian Luca Baiocchi, Simone Giacopuzzi, Daniele Marrelli, Daniel Reim, Guillaume Piessen, Paulo Matos da Costa, John V. Reynolds, Hans Joachim Meyer, Paolo Morgagni, Ines Gockel, Lucio Lara Santos, Lone Susanne Jensen, Thomas Murphy, Shaun R. Preston, Mikhail Ter-Ovanesov, Uberto Fumagalli Romario, Maurizio Degiuli, Wojciech Kielan, Stefan Mönig, Piotr KołodziejczykWojciech Polkowski, Richard Hardwick, Manuel Pera, Jan Johansson, Paul M. Schneider, Wobbe O. de Steur, Suzanne S. Gisbertz, Henk Hartgrink, Joanna W. van Sandick, Nazario Portolani, Arnulf H. Hölscher, Maristella Botticini, Franco Roviello, Christophe Mariette, William Allum, Giovanni De Manzoni

Research output: Contribution to journalArticleResearch

82 Citations (Scopus)


© 2018, The International Gastric Cancer Association and The Japanese Gastric Cancer Association. Background: Perioperative complications can affect outcomes after gastrectomy for cancer, with high mortality and morbidity rates ranging between 10 and 40%. The absence of a standardized system for recording complications generates wide variation in evaluating their impacts on outcomes and hinders proposals of quality-improvement projects. The aim of this study was to provide a list of defined gastrectomy complications approved through international consensus. Methods: The Gastrectomy Complications Consensus Group consists of 34 European gastric cancer experts who are members of the International Gastric Cancer Association. A group meeting established the work plan for study implementation through Delphi surveys. A consensus was reached regarding a set of standardized methods to define gastrectomy complications. Results: A standardized list of 27 defined complications (grouped into 3 intraoperative, 14 postoperative general, and 10 postoperative surgical complications) was created to provide a simple but accurate template for recording individual gastrectomy complications. A consensus was reached for both the list of complications that should be considered major adverse events after gastrectomy for cancer and their specific definitions. The study group also agreed that an assessment of each surgical case should be completed at patient discharge and 90 days postoperatively using a Complication Recording Sheet. Conclusion: The list of defined complications (soon to be validated in an international multicenter study) and the ongoing development of an electronic datasheet app to record them provide the basic infrastructure to reach the ultimate goals of standardized international data collection, establishment of benchmark results, and fostering of quality-improvement projects.
Original languageEnglish
Pages (from-to)172-189
JournalGastric Cancer
Publication statusPublished - 22 Jan 2019


  • Clavien–Dindo classification
  • Comprehensive Complications Index
  • Gastrectomy
  • Gastric cancer
  • International consensus
  • Perioperative complications


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