[Recognition of postoperative complication after surgery for gastric cancer]

Complications significantly postpone postoperative recovery and increase mortality after gastric cancer surgery. However, varied complication rates have been reported in the literature as well as in our annual report of China Gastrointestinal Oncological Surgery League. It appears that there have been some misunderstandings regarding the diagnosis and interventions as well as the etiology of major complications. We should be aware of the fact that reaching worldwide consensus for the diagnostic criteria is a difficult task in most complications, which disabled the possibility of data comparison among different studies in most cases. Disagreements among the Chinese and western surgeons in the complication diagnosis should also be acknowledged when interpreting data from both ends. The western colleagues appreciate more latent manifestations of the complications, which eventually lead to earlier and more aggressive examinations and interventions. We, together with all Chinese centers, need to acknowledge the differences, ensure the integrity of our reported data while proposing respective countermeasures. Although the complication registration may continue to differ among centers, we can register complications with the intervention details so that the reported complications can be classified with the same standard (i.e. Clavien-Dindo scoring system). We should also encourage multi-center collaborations and trials, which facilitate the standardization of complication diagnosis and registration. Recognizing the difficulty and long-course nature of reaching national or even international consensus, we continue aiming at the ultimate goal with our best effort.