Endoscopic approach for postoperative complications following laparoscopic-assisted gastrectomy in early gastric cancer: literature review

Abstract

BACKGROUND/AIMS: Laparoscopic-assisted gastrectomy (LAG) is a minimal invasive surgery for stomach cancer. The endoscopic approach for postoperative complications could reduce re-operation. The aim of our study is to investigate the efficacy of endoscopic procedures and postoperative complications of LAG.

METHODOLOGY: A total of 393 patients who underwent LAG for early gastric cancer were included retrospectively. Technical and clinical success of endoscopic procedures and the relationship between postoperative complications and the types of resection and anastomosis were evaluated.

RESULTS: The mean age of patients was 58 years old and the number of men was 250 (63.8%). Forty five complications occurred in 37 patients (11.5%). Early (within 1 month) and late (after 1 month) postoperative complications occurred in 30 (7.7%) and 6 (1.5%) patients, respectively. Endoscopic procedures were performed for intraluminal bleeding, anastomotic leakage and anastomotic stenosis. Clinical and technical success of endoscopic procedures was 100% (16/16) and 93.8% (15/16) respectively. The occurrence of anastomotic leakage and anastomotic stenosis were significantly high in LATG and Roux-en-Y group than LADG and Billroth-I, and LADG and Billroth-II groups.

CONCLUSIONS: Our study showed that endoscopic procedures could effectively control postoperative anastomotic complications. Anastomotic leakage and stenosis occurred more frequently in patients who underwent LATG with Roux-en-Y anastomosis.