Complications in Laparoscopy-Assisted Gastrectomy: Multivariate Analysis of 300 Consecutive Cases

BACKGROUND: Complications during laparoscopy-assisted gastrectomy (LAG) are not significantly different from those of the open gastrectomy. However, additional risks related with abdominal access, pneumoperitoneum, and special electrosurgical instruments result in increased incidence of complications in LAG. In this study, we analyzed causes and risk factors linked to postoperative morbidity. METHODS: We retrospectively reviewed data of 300 patients who underwent consecutive LAG for gastric cancer at our department from May 2003 to October 2006. Among the 300 patients, total gastrectomy was performed in 42 patients, distal gastrectomy in 258 patients, and proximal gastrectomy in 3 patients. Clinical and operative data obtained included body mass index, medical comorbidities, history of previous abdominal surgery, operative time, type of surgery, extent of lymph node dissection according to the Japanese Guideline, number of retrieved lymph nodes and lymph node metastasis, additional operative procedure, depth of tumor invasion and stage. Outcome data consisted of mortality, major morbidities, and postoperative hospital stay. The 300 patients were divided into 2 periods; 50 cases in the 1st period and 250 cases in the 2nd period. RESULTS: Postoperative complications were developed in 61 cases (20.3%); wound infection in 21 (7.0%), intraabdominal abscess in 3 (1.0%), bleeding in 12 (4.0%), stenosis in 13 (4.3%), leakage in 3 (1.0%), acute pancreatitis in 2 (0.7%), pulmonary complication in 4 (1.3%), renal complication in 4 (1.3%) and cardiac complication in 2 (0.7%). The 30-day mortality rate was 0.7% (n=2). Gender, operative period, comorbidity, and operative times were proved to be important risk factors in univariate analaysis. In multivariate analysis, cormobidity and operative period were proved to be important risk factors. CONCLUSIONS: The data suggest that LAG can be performed with acceptable perioperative complication rates. Experience of surgeon and careful patient selection determined optimal patient outcomes.

Author dc:creator

• 박, 종민

Contributors dc:contributor

• 한, 상욱
• 대학원 의학과
• 200624450

• laparoscopy-assisted gastrectomy
• gastric cancer
• complication
• learning curve

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000009128
000000009128

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1406