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The impact of comorbidity on surgical outcomes in laparoscopy-assisted distal gastrectomy: a retrospective analysis of multicenter results

Authors
 Wook Kim  ;  Kyo Young Song  ;  Hyuk-Joon Lee  ;  Sang Uk Han  ;  Woo Jin Hyung  ;  Gyu Seok Cho 
Citation
 ANNALS OF SURGERY, Vol.248(5) : 793-799, 2008 
Journal Title
ANNALS OF SURGERY
ISSN
 0003-4932 
Issue Date
2008
MeSH
Adult ; Cerebrovascular Disorders/epidemiology ; Comorbidity ; Diabetes Mellitus/epidemiology ; Female ; Gastrectomy/methods* ; Heart Diseases/epidemiology ; Humans ; Hypertension/epidemiology ; Laparoscopy ; Multivariate Analysis ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/epidemiology* ; Stomach Neoplasms/surgery*
Keywords
Adult ; Cerebrovascular Disorders/epidemiology ; Comorbidity ; Diabetes Mellitus/epidemiology ; Female ; Gastrectomy/methods* ; Heart Diseases/epidemiology ; Humans ; Hypertension/epidemiology ; Laparoscopy ; Multivariate Analysis ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/epidemiology* ; Stomach Neoplasms/surgery*
Abstract
OBJECTIVE: The purpose of this study was to evaluate the impact of comorbidities on the surgical outcomes in laparoscopy-assisted distal gastrectomy (LADG).

SUMMARY BACKGROUND DATA: Although laparoscopic gastrectomy is less invasive than conventional open surgery, surgeons are still concerned with surgical outcomes associated with comorbidity.

METHODS: We retrospectively collected data on 1324 patients who underwent LADG between April 1998 and December 2005 by 10 surgeons in 10 hospitals. After excluding 87 patients who had an unusual medical history or surgical methods, 1237 patients were enrolled for analysis to evaluate the effect of comorbidities on the surgical outcomes.

RESULTS: Seven patients (0.6%) died during their hospitalization, and postoperative complications occurred in 162 (13.1%) of 1237 patients. According to univariate analysis, gender, number of comorbidities, reconstruction type, and the surgeon's experience in laparoscopy-assisted gastrectomy (LAG) were related to postoperative local complications; age and comorbidity were related to systemic complications; and comorbidity was the only variable related to hospital mortality. Comorbidity was a predictive risk factor for local complications (odds ratio (OR): 1.79) and systemic complications (OR: 2.89) in multivariate analysis. The patients with pulmonary comorbidity were related to most types of immediate postoperative complications compared with other comorbidities.

CONCLUSIONS: Our study suggests that comorbidities of patients could be a predictive risk factor for surgical complication after LADG. Therefore, patients with early gastric cancer having comorbidity should be considered for one of the limited surgeries. In addition, surgeons should carefully assess patients with comorbidities with full perioperative attention.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000658-200811000-00014&LSLINK=80&D=ovft
DOI
10.1097/SLA.0b013e3181887516
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107877
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