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Surgical Complications and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer

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

Abstract

Background

Information on surgical complications of laparoscopy-assisted distal gastrectomy (LADG) and their risk factors is limited in the literature despite increasing popularity of this procedure. This study was performed to identify the surgical complications and their associated risk factors of LADG in early gastric cancer.

Methods

LADG was performed in 347 gastric cancer patients from January 2002 to December 2006 at the Korean National Cancer Center by four surgeons with ample experience of open gastric surgery before LADG. LADG indications for cases of gastric cancer at our institution are preoperatively diagnosed cT1N0 or cT1N1, except in cases with an absolute indication for endoscopic resection. Lymph node dissection of more than D1 + β was performed in all patients. Intraoperative and postoperative complications were reviewed and their risk factors were retrospectively analyzed by prospective database information.

Results

Forty complications occurred in 34 patients (9.8%), but there was no mortality. Intraoperative complications occurred in nine patients (2.6%), and open conversion was performed in eight (2.3%) of these patients. Early and late postoperative complications occurred in 21 (6.1%) and 10 (2.9%) patients, respectively. The most serious complication was vascular injury resulting in bleeding or organ ischemia, which occurred in seven patients. Degree of lymph node dissection and surgical inexperience were found to be risk factors of surgical complication (P = .023, odds ratio 2.832, 95% confidence interval 1.155–6.946 vs. P = .028, odds ratio 2.975, 95% confidence interval 1.127–7.854).

Conclusions

Lymph node dissection during LADG should be performed cautiously to prevent surgical complications like vascular injuries, especially during the surgeon’s early learning period.

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Acknowledgment

Supported by grants 0610500-2 and 0610070-2 from the National Cancer Center, Korea.

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Authors and Affiliations

  1. Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea

    Keun Won Ryu MD, Young-Woo Kim MD, Jun Ho Lee MD, Myeong-Cherl Kook MD, Il Ju Choi MD & Jae-Moon Bae MD

  2. Cancer Registration and Biostatistics Branch, Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea

    Byung-Ho Nam PhD

Authors
  1. Keun Won Ryu MD
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  2. Young-Woo Kim MD
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  3. Jun Ho Lee MD
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  4. Byung-Ho Nam PhD
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  5. Myeong-Cherl Kook MD
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  6. Il Ju Choi MD
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  7. Jae-Moon Bae MD
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Correspondence to Young-Woo Kim MD.

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Ryu, K.W., Kim, YW., Lee, J.H. et al. Surgical Complications and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy in Early Gastric Cancer. Ann Surg Oncol 15, 1625–1631 (2008). https://doi.org/10.1245/s10434-008-9845-x

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  • DOI: https://doi.org/10.1245/s10434-008-9845-x

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