J Minim Invasive Surg.  2018 Mar;21(1):13-24. 10.7602/jmis.2018.21.1.13.

Analysis of Postoperative Complications Following Laparoscopic Gastrectomy in 1332 Gastric Cancer Patients

Affiliations
  • 1Department of Surgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea. getz0622@naver.com
  • 2Department of Surgery, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Department of Pathology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

Abstract

PURPOSE
To analyze postoperative complications for gastric cancer patients undergoing laparoscopic gastrectomy in single institution over long period of time.
METHODS
The data of 1332 consecutive patients undergoing laparoscopic gastrectomy for gastric cancer at a single institution from January 2007 to December 2015 were reviewed. The patients were classified into the early or late surgery group; the initial 100 cases were classified as the initial group. We compared between the two groups and analyzed risk factors for postoperative complications.
RESULTS
A total of 265 postoperative complications occurred in 223 patients (16.7%). Major complications occurred in 38 patients (2.9%) including 1 death (0.1%). Operative time and hospital stay were significantly shorter in the late group. Blood loss was greater in the initial group. Sex, comorbidity, tumor location, D2 LND, operative method, non B-I anastomosis, co-resection, long operative time, and blood loss were significant risk factors for overall postoperative complication. In the multivariate analysis, male sex, comorbidity, D2 lymph node dissection, total or proximal gastrectomy, non B-I anastomosis, co-resection, operative time and blood loss were associated with postoperative overall complications.
CONCLUSION
Sex, co-morbidity, D2 LND, operative method, co-resection, operative time and blood loss revealed as the risk factor of overall postoperative complication. And there was no significant differences of risk factor related to postoperative complication between initial and maturation surgical period. This suggests that beginners also can safely perform laparoscopic gastrectomy through the appropriate patient selection.

Keyword

Postoperative complication; Gastrectomy; Laparoscopy; Minimal invasive surgery; Gastric cancer
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