Ann Surg Treat Res.  2014 May;86(5):237-243. 10.4174/astr.2014.86.5.237.

Comprehension of readmission after laparoscopy assisted distal gastrectomy: what are the causes?

• Kim MC
• Kim KH
• Kim YM
• Jung GJ

• KMID: 1889660
• DOI: http://doi.org/10.4174/astr.2014.86.5.237

Abstract

PURPOSE
The aim of this study is to evaluate long-term outcomes regarding readmission for laparoscopy-assisted distal subtotal gastrectomy (LADG) compared to conventional open distal subtotal gastrectomy (CODG) for early gastric cancer (EGC).
METHODS
Between January 2003 and December 2006, 223 and 106 patients underwent LADG and CODG, respectively, for EGC by one surgeon. The clinicopathologic characteristics, postoperative outcomes, postoperative complications, overall 5-year survival, recurrence, and readmission were retrospectively compared between the two groups.
RESULTS
Multiple readmission rate in LADG was significantly less than that in CODG (0.4% vs. 3.8%, P = 0.039), although the readmission rate, reoperation rate after discharge, and mean readmission days were not significantly different between the two groups. Readmission rates of the LADG and CODG groups were 12.6% and 14.2%, respectively. First flatus time and postoperative hospital stay was significantly shorter in the LADG group. However, there was no significant difference in the complication rates between the two groups. Overall 5-year survival rates of the LADG and CODG group were 100% and 99.1% (P = 0.038), respectively.
CONCLUSION
Compared to the CODG group, the LADG group has several advantages in surgical short-term outcome and some benefit in terms of readmission in surgical long-term outcome for patients with EGC, even though the oncologic outcome of LADG is similar to that of CODG over 5 years.

Keyword

Laparoscopy; Gastrectomy; Gastric neoplasms; Patient readmission; Prognosis

MeSH Terms

Comprehension*
Flatulence
Gastrectomy*
Humans
Laparoscopy*
Length of Stay
Patient Readmission
Postoperative Complications
Prognosis
Recurrence
Reoperation
Retrospective Studies
Stomach Neoplasms
Survival Rate

Figure

• 

  Fig. 1 Comparison of 5-year survival rate (A) and disease free survival rate (B) between LADG and CODG. The 5-year survival rates were statistically different between both groups (100% vs. 99.1%, P = 0.038), respectively, while there was no statistical difference in 5-year disease free survival rates between both groups (99.5% vs. 99.1%, P = 0.195), respectively. LADG, laparoscopy-assisted distal gastrectomy; CODG, conventional open distal gastrectomy.

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