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Postoperative Complications of Laparoscopy-assisted Gastrectomy in Early Gastric Cancer: The Importance of Precise Preoperative Staging

Authors
Kim, Min-KyoonPark, Joong-MinChi, Kyong-ChounKim, Chong-Suk
Issue Date
11월-2010
Publisher
KOREAN SURGICAL SOCIETY
Keywords
Laparoscopy-assisted gastrectomy; Complication; Risk factor; Lymph node metastasis
Citation
JOURNAL OF THE KOREAN SURGICAL SOCIETY, v.79, no.5, pp.340 - 348
Indexed
SCOPUS
KCI
Journal Title
JOURNAL OF THE KOREAN SURGICAL SOCIETY
Volume
79
Number
5
Start Page
340
End Page
348
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/115386
DOI
10.4174/jkss.2010.79.5.340
ISSN
2233-7903
Abstract
Purpose: Although laparoscopy-assisted gastrectomy (LAG) has become a popular treatment option for early gastric cancer, information about postoperative complications is limited in the literature and their risk factors vary among investigators. We analyzed the complications and their risk factors of LAG. Methods: We performed LAGs in 92 gastric cancer patients from July 2006 to December 2009. LAG indication was gastric cancer preoperatively diagnosed as cT1N0. Clinical and operative data and perioperative complications were retrospectively reviewed. According to the surgical experience, cases were divided into early (1 similar to 40) and late (41 similar to 92) groups because operative times stabilized after the 40th case. Results: There were no open conversion or mortality cases. Complications occurred in 11 patients. Two of them were non-surgical complications: postoperative delirium and cerebral infarction. Surgical complications were ischemic necrosis of transverse colon, duodenal stump leakage, anastomotic bleeding, leakage and stenosis. Univariate analysis proved that lymph node metastasis, and comorbidities were related to complication rate (P=0.000, P=0.032). Multivariate analysis proved that lymph node metastasis was the most important risk factor of complication (P=0.001). Surgical experience was not related to complication rate (12.5% in early period and 11.5% in late period, P=1000). Conclusion: Complication rate of LAG was acceptable (11.9%). According to this study, unexpected lymph node metastasis is thought to be the most important risk factor for complications of TAG. Therefore, it is possible to accomplish lower complication rates in this procedure with careful patient selection through accurate preoperative evaluation. (J Korean Surg Soc 2010;79:340-348)
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