Annals of Surgical Oncology

, Volume 15, Issue 10, pp 2692–2700

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
Gastrointestinal Oncology

DOI: 10.1245/s10434-008-0075-z

Cite this article as:
Kim, M.C., Kim, W., Kim, H.H. et al. Ann Surg Oncol (2008) 15: 2692. doi:10.1245/s10434-008-0075-z

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.

Keywords

Gastric cancerLaparoscopy-assisted gastrectomyLymph node dissectionPostoperative morbidityRisk factor

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Min Chan Kim
    • 1
  • Wook Kim
    • 2
  • Hyung Ho Kim
    • 3
  • Seung Wan Ryu
    • 4
  • Seong Yeob Ryu
    • 5
  • Kyo Young Song
    • 6
  • Hyuk Joon Lee
    • 7
  • Gyu Seok Cho
    • 8
  • Sang Uk Han
    • 9
  • Woo Jin Hyung
    • 10
  • Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group
    • 11
  1. 1.Department of SurgeryDong-A University College of MedicineBusanKorea
  2. 2.Holy Family HospitalThe Catholic University of KoreaBucheonSouth Korea
  3. 3.Bundang HospitalSeoul National UniversitySeongnamKorea
  4. 4.Keimyung University School of MedicineDaeguKorea
  5. 5.Chonnam National University School of MedicineGwangjuKorea
  6. 6.The Catholic University of KoreaSeoulKorea
  7. 7.Seoul National University College of MedicineSeoulSouth Korea
  8. 8.Soonchunhyang University College of MedicineBucheonKorea
  9. 9.Ajou University College of MedicineSuwonKorea
  10. 10.Department of SurgeryYonsei University College of MedicineSeoulKorea
  11. 11.SeoulSouth Korea