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

 Min Chan Kim  ;  Wook Kim  ;  Hyung Ho Kim  ;  Seung Wan Ryu  ;  Seong Yeob Ryu  ;  Kyo Young Song  ;  Hyuk Joon Lee  ;  Gyu Seok Cho  ;  Sang Uk Han  ;  Woo Jin Hyung  ;  Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group 
 ANNALS OF SURGICAL ONCOLOGY, Vol.15(10) : 2692-2700, 2008 
Journal Title
Issue Date
Gastric cancer Laparoscopy-assisted gastrectomy Lymph node dissection Postoperative morbidity Risk factor
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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