Analysis of Postoperative Complications and Their Risk Factors after Laparoscopic-Assisted Radical Surgery for Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUZuo-liang ,  ZHOUTong , ZHANGGuang-jun

Department of Gastrointestinal Surgery, Institute of Hepatobiliary, Pancreas, and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China;

Corresponding?author：

ZHOUTong, Email: zhoutong0088@163.com

Keywords：

Gastric cancer; Laparoscopic-assisted radical surgery for gastric cancer; Complication; Risk factor; Prognosis

DOI：

10.7507/1007-9424.20150287

Video：

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Objective To investigate postoperative complications and their risk factors after laparoscopic-assisted radical surgery for gastric cancer. Methods The clinical data of 300 patients with gastric cancer who underwent laparoscopic-assisted radical surgery in Affiliated Hospital of North Sichuan Medical College from October 2010 to October 2013 were analyzed retrospectively. Risk factors associated with postoperative complications were assessed by univariate and multivariate analysis, and survival situation of patient with postoperative complications and without postoperative complications was compared by log-rank test. Results Of the 300 patients, postoperative complications occurred in 51 patients (17.0%). Univariate analysis results showed that, postoperative complication was associate with age, preoperative comorbidity, American Society of Anesthesiologists (ASA) grade, operative time, and experience of surgeon (P<0.050). Logistic regression analysis results revealed that, age, preoperative comorbidity, and experience of surgeon were independent risk factors for postoperative complications (P<0.050), patients with old age, preoperative comorbidity, and underwent surgery by less experience of surgeon had higher incidence of postoperative complication. Two hundred and forty patients were followed-up for 3-35 months, with the median time of 21 months. There was no significant difference in survival situation between patients with and without postoperative complications (χ²=0.941,P=0.332). Conclusion Age, preoperative comorbidity, and experience of surgeon are independent risk factors for postoperative complicatons after laparoscopic-assisted radical surgery for gastric cancer, and the survival situation between patients with and without postoperative complications is similar.

Citation： LIUZuo-liang, ZHOUTong, ZHANGGuang-jun. Analysis of Postoperative Complications and Their Risk Factors after Laparoscopic-Assisted Radical Surgery for Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1107-1111. doi: 10.7507/1007-9424.20150287 Copy

1.	?Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3):144-150.
2.	Lee SR, Kim HO, Son BH, et al. Laparoscopic-assisted total gastrectomy versus open total gastrectomy for upper and middle gastric cancer in short-term and long-term outcomes. Surg Laparosc Endosc Percutan Tech, 2014, 24(3):277-282.
3.	羅武凌. 開腹與腹腔鏡輔助下遠端胃癌D2根治術對進展期胃癌的近期療效分析. 重慶醫學, 2013, 42(19):2222-2224.
4.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted BillrothⅠ gastrectomy. Surg Laparosc Endosc, 1994, 4(2):146-148.
5.	Uyama I, Sugioka A, Fujita J, et al. Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer, 1999, 2(4):230-234.
6.	Choi YY, Bae JM, An JY, et al. Laparoscopic gastrectomy for advanced gastric cancer:are the long-term results comparable with conventional open gastrectomy? A systematic review and meta-analysis. J Surg Oncol, 2013, 108(8):550-556.
7.	周均, 王培紅, 曹永寬, 等. 腹腔鏡輔助進展期胃癌D2根治術與開腹手術近期療效的臨床對照研究. 中國普外基礎與臨床雜志, 2014, 21(1):50-54.
8.	中華醫學會外科學分會內分泌外科學組, 中華醫學會外科學分會腹腔鏡輔助與內鏡外科學組, 中華醫學會外科學分會胃腸外科學組. 中國肥胖病外科治療指南(2007). 中國實用外科雜志, 2007, 27(10):759-762.
9.	Washington K. 7th edition of the AJCC cancer staging manual:stomach. Ann Surg Oncol, 2010, 17(12):3077-3079.
10.	桂林, 蔣鵬程, 管榮祥, 等. 腹腔鏡輔助胃癌D2根治術學習曲線研究. 中國實用外科雜志, 2013, 33(2):146-149.
11.	Cai J, Zhang C, Zhang H, et al. Open versus laparoscopy-assisted D2 radical gastrectomy in advanced upper gastric cancer:a retrospective cohort study. Hepatogastroenterology, 2013, 60(127):1805-1808.
12.	毛婧, 馬繼春, 姜雷, 等. 我國腹腔鏡D2淋巴結清掃術聯合遠端胃癌切除術治療進展期遠端胃癌安全性和療效的系統評價. 中國普外基礎與臨床雜志, 2014, 21(6):707-715.
13.	Chen K, Xu XW, Mou YP, et al. Systematic review and meta-analysis of laparoscopic and open gastrectomy for advanced gastric cancer. World J Surg Oncol, 2013, 11(11):182-194.
14.	Chen K, Xu XW, Zhang RC, et al. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer. World J Gastroenterol, 2013, 19(32):5365-5376.
15.	余佩武. 腹腔鏡胃癌手術的進展與展望. 中國普外基礎與臨床雜志, 2011, 18(2):105-109.
16.	Song J, Lee HJ, Cho GS, et al. Recurrence following laparoscopy-assisted gastrectomy for gastric cancer:a multicenter retrospective analysis of 1 417 patients. Ann Surg Oncol, 2010, 17(7):1777-1786.
17.	Pak KH, Hyung WJ, Son T, et al. Long-term oncologic outcomes of 714 consecutive laparoscopic gastrectomies for gastric cancer:results from the 7-year experience of a single institute. Surg Endosc, 2012, 26(1):130-136.
18.	Etoh T, Inomata M, Shiraishi N, et al. Revisional surgery after gastrec-tomy for gastric cancer:review of the literature. Surg Laparosc Endosc Percutan Tech, 2010, 20(5):332-337.
19.	黃昌明, 林建賢, 鄭朝輝, 等. 腹腔鏡輔助胃癌根治術后并發癥及其相關因素分析. 中華胃腸外科雜志, 2011, 14(5):347-351.
20.	所劍, 王大廣, 張洋. 腹腔鏡胃癌D2根治術的評價. 第三軍醫大學學報, 2013, 35(18):1893-1895.
21.	孫少川, 周鑫, 鄭春寧, 等. 腹腔鏡輔助胃癌根治術的可行性探討. 腹腔鏡外科雜志, 2012, 17(5):342-345.
22.	Yoshikawa T, Cho H, Rino Y, et al. A prospective feasibility and safety study of laparoscopy-assisted distal gastrectomy for clinical stage Ⅰ gastric cancer initiated by surgeons with much experience of open gastrectomy and laparoscopic surgery. Gastric Cancer, 2013, 16(2):126-132.
23.	朱純超, 湯佳音, 趙剛, 等. 腹腔鏡輔助遠端胃癌根治術學習曲線研究. 中國微創外科雜志, 2013, 13(12):1105-1108.
24.	周均, 曹永寬, 宋亞寧, 等. 手助腹腔鏡胃癌 D2根治術的團隊配合. 中國微創外科雜志, 2014, 14(10):892-895.
25.	余佩武, 唐波. 腹腔鏡胃癌根治術技術難點與對策. 中國實用外科雜志, 2010, 30(3):178-180.
26.	Li GX, Zhang C, Yu J, et al. A new order of D2 lymphadenectomy in laparoscopic gastrectomy for cancer:live anatomy-based dissection. Minim Invasive Ther Allied Technol, 2010, 19(6):355-363.
27.	Zhang F, Sun D, Yang B, et al. Cooperative techniques for surgical assistants in laparoscopy-assisted radical distal gastrectomy for gastric cancer. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):345-348.

1. ?Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3):144-150.
2. Lee SR, Kim HO, Son BH, et al. Laparoscopic-assisted total gastrectomy versus open total gastrectomy for upper and middle gastric cancer in short-term and long-term outcomes. Surg Laparosc Endosc Percutan Tech, 2014, 24(3):277-282.
3. 羅武凌. 開腹與腹腔鏡輔助下遠端胃癌D2根治術對進展期胃癌的近期療效分析. 重慶醫學, 2013, 42(19):2222-2224.
4. Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted BillrothⅠ gastrectomy. Surg Laparosc Endosc, 1994, 4(2):146-148.
5. Uyama I, Sugioka A, Fujita J, et al. Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer, 1999, 2(4):230-234.
6. Choi YY, Bae JM, An JY, et al. Laparoscopic gastrectomy for advanced gastric cancer:are the long-term results comparable with conventional open gastrectomy? A systematic review and meta-analysis. J Surg Oncol, 2013, 108(8):550-556.
7. 周均, 王培紅, 曹永寬, 等. 腹腔鏡輔助進展期胃癌D2根治術與開腹手術近期療效的臨床對照研究. 中國普外基礎與臨床雜志, 2014, 21(1):50-54.
8. 中華醫學會外科學分會內分泌外科學組, 中華醫學會外科學分會腹腔鏡輔助與內鏡外科學組, 中華醫學會外科學分會胃腸外科學組. 中國肥胖病外科治療指南(2007). 中國實用外科雜志, 2007, 27(10):759-762.
9. Washington K. 7th edition of the AJCC cancer staging manual:stomach. Ann Surg Oncol, 2010, 17(12):3077-3079.
10. 桂林, 蔣鵬程, 管榮祥, 等. 腹腔鏡輔助胃癌D2根治術學習曲線研究. 中國實用外科雜志, 2013, 33(2):146-149.
11. Cai J, Zhang C, Zhang H, et al. Open versus laparoscopy-assisted D2 radical gastrectomy in advanced upper gastric cancer:a retrospective cohort study. Hepatogastroenterology, 2013, 60(127):1805-1808.
12. 毛婧, 馬繼春, 姜雷, 等. 我國腹腔鏡D2淋巴結清掃術聯合遠端胃癌切除術治療進展期遠端胃癌安全性和療效的系統評價. 中國普外基礎與臨床雜志, 2014, 21(6):707-715.
13. Chen K, Xu XW, Mou YP, et al. Systematic review and meta-analysis of laparoscopic and open gastrectomy for advanced gastric cancer. World J Surg Oncol, 2013, 11(11):182-194.
14. Chen K, Xu XW, Zhang RC, et al. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer. World J Gastroenterol, 2013, 19(32):5365-5376.
15. 余佩武. 腹腔鏡胃癌手術的進展與展望. 中國普外基礎與臨床雜志, 2011, 18(2):105-109.
16. Song J, Lee HJ, Cho GS, et al. Recurrence following laparoscopy-assisted gastrectomy for gastric cancer:a multicenter retrospective analysis of 1 417 patients. Ann Surg Oncol, 2010, 17(7):1777-1786.
17. Pak KH, Hyung WJ, Son T, et al. Long-term oncologic outcomes of 714 consecutive laparoscopic gastrectomies for gastric cancer:results from the 7-year experience of a single institute. Surg Endosc, 2012, 26(1):130-136.
18. Etoh T, Inomata M, Shiraishi N, et al. Revisional surgery after gastrec-tomy for gastric cancer:review of the literature. Surg Laparosc Endosc Percutan Tech, 2010, 20(5):332-337.
19. 黃昌明, 林建賢, 鄭朝輝, 等. 腹腔鏡輔助胃癌根治術后并發癥及其相關因素分析. 中華胃腸外科雜志, 2011, 14(5):347-351.
20. 所劍, 王大廣, 張洋. 腹腔鏡胃癌D2根治術的評價. 第三軍醫大學學報, 2013, 35(18):1893-1895.
21. 孫少川, 周鑫, 鄭春寧, 等. 腹腔鏡輔助胃癌根治術的可行性探討. 腹腔鏡外科雜志, 2012, 17(5):342-345.
22. Yoshikawa T, Cho H, Rino Y, et al. A prospective feasibility and safety study of laparoscopy-assisted distal gastrectomy for clinical stage Ⅰ gastric cancer initiated by surgeons with much experience of open gastrectomy and laparoscopic surgery. Gastric Cancer, 2013, 16(2):126-132.
23. 朱純超, 湯佳音, 趙剛, 等. 腹腔鏡輔助遠端胃癌根治術學習曲線研究. 中國微創外科雜志, 2013, 13(12):1105-1108.
24. 周均, 曹永寬, 宋亞寧, 等. 手助腹腔鏡胃癌 D2根治術的團隊配合. 中國微創外科雜志, 2014, 14(10):892-895.
25. 余佩武, 唐波. 腹腔鏡胃癌根治術技術難點與對策. 中國實用外科雜志, 2010, 30(3):178-180.
26. Li GX, Zhang C, Yu J, et al. A new order of D2 lymphadenectomy in laparoscopic gastrectomy for cancer:live anatomy-based dissection. Minim Invasive Ther Allied Technol, 2010, 19(6):355-363.
27. Zhang F, Sun D, Yang B, et al. Cooperative techniques for surgical assistants in laparoscopy-assisted radical distal gastrectomy for gastric cancer. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):345-348.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Postoperative Complications and Their Risk Factors after Laparoscopic-Assisted Radical Surgery for Gastric Cancer

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