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.	罗武凌. 开腹与腹腔镜辅助下远端胃癌D2根治术对进展期胃癌的近期疗效分析. 重庆医学, 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, 王培红, 曹永宽, 等. 腹腔镜辅助进展期胃癌D2根治术与开腹手术近期疗效的临床对照研究. 中国普外基础与临床杂志, 2014, 21(1):50-54.
8.	中华医学会外科学分会内分泌外科学组, 中华医学会外科学分会腹腔镜辅助与内镜外科学组, 中华医学会外科学分会胃肠外科学组. 中国肥胖病外科治疗指南(2007). 中国实用外科杂志, 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, 蒋鹏程, 管荣祥, 等. 腹腔镜辅助胃癌D2根治术学习曲线研究. 中国实用外科杂志, 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, 马继春, 姜雷, 等. 我国腹腔镜D2淋巴结清扫术联合远端胃癌切除术治疗进展期远端胃癌安全性和疗效的系统评价. 中国普外基础与临床杂志, 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. 腹腔镜胃癌手术的进展与展望. 中国普外基础与临床杂志, 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.	黄昌明, 林建贤, 郑朝辉, 等. 腹腔镜辅助胃癌根治术后并发症及其相关因素分析. 中华胃肠外科杂志, 2011, 14(5):347-351.
20.	所剑, 王大广, 张洋. 腹腔镜胃癌D2根治术的评价. 第三军医大学学报, 2013, 35(18):1893-1895.
21.	孙少川, 周鑫, 郑春宁, 等. 腹腔镜辅助胃癌根治术的可行性探讨. 腹腔镜外科杂志, 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.	朱纯超, 汤佳音, 赵刚, 等. 腹腔镜辅助远端胃癌根治术学习曲线研究. 中国微创外科杂志, 2013, 13(12):1105-1108.
24.	周均, 曹永宽, 宋亚宁, 等. 手助腹腔镜胃癌 D2根治术的团队配合. 中国微创外科杂志, 2014, 14(10):892-895.
25.	余佩武, 唐波. 腹腔镜胃癌根治术技术难点与对策. 中国实用外科杂志, 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. 罗武凌. 开腹与腹腔镜辅助下远端胃癌D2根治术对进展期胃癌的近期疗效分析. 重庆医学, 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, 王培红, 曹永宽, 等. 腹腔镜辅助进展期胃癌D2根治术与开腹手术近期疗效的临床对照研究. 中国普外基础与临床杂志, 2014, 21(1):50-54.
8. 中华医学会外科学分会内分泌外科学组, 中华医学会外科学分会腹腔镜辅助与内镜外科学组, 中华医学会外科学分会胃肠外科学组. 中国肥胖病外科治疗指南(2007). 中国实用外科杂志, 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, 蒋鹏程, 管荣祥, 等. 腹腔镜辅助胃癌D2根治术学习曲线研究. 中国实用外科杂志, 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, 马继春, 姜雷, 等. 我国腹腔镜D2淋巴结清扫术联合远端胃癌切除术治疗进展期远端胃癌安全性和疗效的系统评价. 中国普外基础与临床杂志, 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. 腹腔镜胃癌手术的进展与展望. 中国普外基础与临床杂志, 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. 黄昌明, 林建贤, 郑朝辉, 等. 腹腔镜辅助胃癌根治术后并发症及其相关因素分析. 中华胃肠外科杂志, 2011, 14(5):347-351.
20. 所剑, 王大广, 张洋. 腹腔镜胃癌D2根治术的评价. 第三军医大学学报, 2013, 35(18):1893-1895.
21. 孙少川, 周鑫, 郑春宁, 等. 腹腔镜辅助胃癌根治术的可行性探讨. 腹腔镜外科杂志, 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. 朱纯超, 汤佳音, 赵刚, 等. 腹腔镜辅助远端胃癌根治术学习曲线研究. 中国微创外科杂志, 2013, 13(12):1105-1108.
24. 周均, 曹永宽, 宋亚宁, 等. 手助腹腔镜胃癌 D2根治术的团队配合. 中国微创外科杂志, 2014, 14(10):892-895.
25. 余佩武, 唐波. 腹腔镜胃癌根治术技术难点与对策. 中国实用外科杂志, 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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