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Risk Factors Associated with Complication Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Large-Scale Korean Multicenter Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Surgery, Dong-A University College of Medicine, Busan, Korea

    Min Chan Kim MD

  2. Holy Family Hospital, The Catholic University of Korea, Bucheon, South Korea

    Wook Kim MD

  3. Bundang Hospital, Seoul National University, Seongnam, Korea

    Hyung Ho Kim MD

  4. Keimyung University School of Medicine, Daegu, Korea

    Seung Wan Ryu MD

  5. Chonnam National University School of Medicine, Gwangju, Korea

    Seong Yeob Ryu MD

  6. The Catholic University of Korea, Seoul, Korea

    Kyo Young Song MD

  7. Seoul National University College of Medicine, Seoul, South Korea

    Hyuk Joon Lee MD

  8. Soonchunhyang University College of Medicine, Bucheon, Korea

    Gyu Seok Cho MD

  9. Ajou University College of Medicine, Suwon, Korea

    Sang Uk Han MD

  10. Department of Surgery, Yonsei University College of Medicine, 134 Shinchondong Seodaemunku, Seoul, 120-752, Korea

    Woo Jin Hyung MD

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  1. Min Chan Kim MD
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  2. Wook Kim MD
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  3. Hyung Ho Kim MD
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Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group

Corresponding author

Correspondence to Woo Jin Hyung MD.

Additional information

All the authors are for Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group.

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Kim, M.C., Kim, W., Kim, H.H. et al. Risk Factors Associated with Complication Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Large-Scale Korean Multicenter Study. Ann Surg Oncol 15, 2692–2700 (2008). https://doi.org/10.1245/s10434-008-0075-z

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  • DOI: https://doi.org/10.1245/s10434-008-0075-z

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