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Laparoscopic gastrectomy for patients with a history of upper abdominal surgery: results of a matched-pair analysis

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The safety and feasibility of laparoscopic gastrectomy (LG) for patients who have undergone previous upper abdominal surgery (PUAS) remain unclear. A matched-pair analysis was conducted to compare the short-term outcomes of LG between patients with gastric cancer who had undergone PUAS and those who had not.


A matched-pair analysis was performed to compare the short-term outcomes of LG between 22 patients who had undergone PUAS and 66 who had not (control group). To compare the outcome to that of open gastrectomy (OG) following PUAS, a total of 143 consecutive OG patients treated during the same study period were also reviewed.


Cholecystectomy was the most common type of PUAS, followed by gastrectomy. There were no significant differences between the groups in terms of the length of the operation, blood loss, and the number of retrieved lymph nodes or the rate of conversion to open surgery. The postoperative morbidity in the PUAS group (3/22, 13.6 %) was comparable to that of the control group (7/66, 10.6 %, P = 0.6981). There was no mortality within 30 days in either group. When compared to OG following PUAS (n = 23), LG was performed with significantly less blood loss with an equivalent postoperative outcome.


LG following PUAS is considered to be a safe and feasible surgical modality. PUAS should therefore not be regarded as a contraindication for LG.

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  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.

    Article  PubMed  Google Scholar 

  2. Nakajima T. Gastric cancer treatment guidelines in Japan. Gastric Cancer. 2002;5:1–5.

    Article  PubMed  Google Scholar 

  3. Van Cutsem E, Van de Velde C, Roth A, Lordick F, Köhne CH, Cascinu S, et al. Expert opinion on management of gastric and gastro-oesophageal junction adenocarcinoma on behalf of the European Organisation for Research and Treatment of Cancer (EORTC)-gastrointestinal cancer group. Eur J Cancer. 2008;44:182–94.

    Article  PubMed  Google Scholar 

  4. Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, et al. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13:238–44.

    Article  PubMed  Google Scholar 

  5. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg. 2005;241:232–7.

    Article  PubMed  Google Scholar 

  6. Lee SW, Nomura E, Bouras G, Tokuhara T, Tsunemi S, Tanigawa N. Long-term oncologic outcomes from laparoscopic gastrectomy for gastric cancer: a single-center experience of 601 consecutive resections. J Am Coll Surg. 2010;211:33–40.

    Article  PubMed  Google Scholar 

  7. Park DJ, Han SU, Hyung WJ, Kim MC, Kim W, Ryu SY, et al. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective study. Surg Endosc. 2012;26:1548–53.

    Article  Google Scholar 

  8. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. Japanese Laparoscopic Surgery Study Group: a multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.

    Article  PubMed  Google Scholar 

  9. UICC International Union Against Cancer: TNM classification of malignant tumours. 7th ed. New York: Wiley-Blackwell; 2009.

  10. Tanigawa N, Lee SW, Kimura T, Mori T, Uyama I, Nomura E, et al. The endoscopic surgical skill qualification system for gastric surgery in Japan. Asian J Endosc Surg. 2011;4:112–5.

    Article  CAS  PubMed  Google Scholar 

  11. Obama K, Okabe H, Hosogi H, Tanaka E, Itami A, Sakai Y. Feasibility of laparoscopic gastrectomy with radical lymph node dissection for gastric cancer: from a viewpoint of pancreas-related complications. Surgery. 2011;149:15–21.

    Article  PubMed  Google Scholar 

  12. Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, et al. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg. 2002;195:284–7.

    Article  PubMed  Google Scholar 

  13. Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, et al. Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc. 2009;23:2167–71.

    Article  PubMed  Google Scholar 

  14. Okabe H, Obama K, Kan T, Tanaka E, Itami A, Sakai Y. Medial approach for laparoscopic total gastrectomy with splenic lymph node dissection. J Am Coll Surg. 2010;211:e1–6.

    Article  PubMed  Google Scholar 

  15. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.

    Article  Google Scholar 

  16. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  17. Tokunaga M, Hiki N, Fukunaga T, Nunobe S, Ohyama S, Yamaguchi T. Laparoscopy-assisted gastrectomy for patients with earlier upper abdominal open surgery. Surg Laparosc Endosc Percutan Tech. 2010;20:16–9.

    Article  PubMed  Google Scholar 

  18. Curet MJ. Special problems in laparoscopic surgery. Previous abdominal surgery, obesity, and pregnancy. Surg Clin North Am. 2000;80:1093–110.

    Article  CAS  PubMed  Google Scholar 

  19. Arteaga González I, Martín Malagón A, López-Tomassetti Fernández EM, Arranz Durán J, Díaz Luis H, Carrillo Pallares A. Impact of previous abdominal surgery on colorectal laparoscopy results: a comparative clinical study. Surg Laparosc Endosc Percutan Tech. 2006;16:8–11.

    Article  PubMed  Google Scholar 

  20. Barleben A, Gandhi D, Nguyen XM, Che F, Nguyen NT, Mills S, et al. Is laparoscopic colon surgery appropriate in patients who have had previous abdominal surgery? Am Surg. 2009;75:1015–9.

    PubMed  Google Scholar 

  21. Law WL, Lee YM, Chu KW. Previous abdominal operations do not affect the outcomes of laparoscopic colorectal surgery. Surg Endosc. 2005;19:326–30.

    Article  CAS  PubMed  Google Scholar 

  22. Lee JH, Ryu KW, Park SR, Kim CG, Kook MC, Nam BH, et al. Learning curve for total gastrectomy with D2 lymph node dissection: cumulative sum analysis for qualified surgery. Ann Surg Oncol. 2006;13:1175–81.

    Article  PubMed  Google Scholar 

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None of the authors have any biomedical financial interest or potential conflicts of interest to declare.

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Correspondence to Hiroshi Okabe.

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Tsunoda, S., Okabe, H., Obama, K. et al. Laparoscopic gastrectomy for patients with a history of upper abdominal surgery: results of a matched-pair analysis. Surg Today 44, 271–276 (2014).

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