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Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale korean multicenter study.

Authors
Kim, MC; Kim, W; Kim, HH; Ryu, SW; Ryu, SY; Song, KY; Lee, HJ; Cho, GS; Han, SU; Hyung, WJ
Citation
Annals of surgical oncology, 15(10):2692-2700, 2008
Journal Title
Annals of surgical oncology
ISSN
1068-92651534-4681
Abstract
BACKGROUND: The aim of this multicenter retrospective study was to establish background data for future randomized clinical trial comparing open and laparoscopy-assisted gastrectomies (LAGs). We sought to evaluate the technical feasibility of LAG by determining the morbidity and mortality and identifying corresponding predictive factors. PATIENTS AND METHODS: A retrospective multicenter study was carried out in Korea on 1,485 patients in who, LAG had been attempted for gastric cancer under the care of ten surgeons, at ten institutions, during the period spanning May 1998 to December 2005. Patient characteristics, operative outcomes, and postoperative morbidities and mortalities were analyzed. RESULTS: Overall morbidity and mortality rates were 14.0% and 0.6%, respectively. Complications included: wound problem (4.2%, n = 62), intraluminal bleeding (1.3%, n = 20), intra-abdominal abscess or fluid collection (1.3%, n = 19), anastomotic leakage (1.3%, n = 18), and intra-abdominal bleeding (1.3%, n = 18). By using multivariate analysis we found that the two most important risk factors associated with postoperative complications were presence of comorbidity in the patient and lack of experience on the part of the surgeon. CONCLUSION: LAG is a technically feasible, safe, and effective method for treating patients with gastric cancer. Extra caution in patients with comorbidities, and dedication to improving surgical proficiency in LAG, may decrease the risk of complications. Through this study, we have established the inclusion criteria for LAG. For our multicenter, prospective, randomized trials (NCT00452751), potential patients should have an American Society of Anesthesiology (ASA) score of less than 3, and surgeons performing the procedures should have experience with more than 50 cases of LAG.
MeSH terms
AdultAgedAged, 80 and overFeasibility StudiesFemaleGastrectomy/adverse effects*HumansKoreaLaparoscopy*MaleMiddle AgedNeoplasm StagingPostoperative Complications*PrognosisRandomized Controlled Trials as TopicRetrospective StudiesRisk FactorsStomach Neoplasms/pathologyStomach Neoplasms/surgery*Survival Rate
DOI
10.1245/s10434-008-0075-z
PMID
18663532
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
한상욱
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