Management and Prophylaxis of Complications in Laparoscopic Gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Jian , HU Xiang.

The First Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 16011, Liaoning Province, China;

Corresponding author：

Keywords：

Gastric cancer; Laparoscopy; Operation; Complication; Prophylaxis; Management

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ObjectiveTo summarize the current status and the management and prophylaxis of complications in laparoscopic gastrectomy. MethodsThe literatures on laparoscopic gastrectomy in domestic and abroad were reviewed and analyzed combined with our experiences. ResultsThe complications of laparoscopic gastrectomy primary attributed to surgery itself and pneumoperitoneum. Limited field under laparoscopy, loss of threedimensional space and finger touch, new instrument and technology and working conditions increased the difficulty of operation and the possibility of surgical complications. Clear anatomical layer under laparoscopy, accurate dissection of lymph nodes, and digestive tract reconstruction were the basis to reduce the complications in laparoscopic gastrectomy. ConclusionCorrect surgical procedures may reduce the occurrence of complications in laparoscopic gastrectomy.

Citation： ZHANG Jian,HU Xiang.. Management and Prophylaxis of Complications in Laparoscopic Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 122-125. doi: Copy

1.	Kitano S, Iso Y, Moriyama M, et al. Laparoscopyassisted Billroth Ⅰ gastrectomy [J]. Surg Laparosc Endosc, 1994, 4(2): 146148.
2.	Naka T, Ishikura T, Shibata S, et al. Laparoscopyassisted and open distal gastrectomies for early gastric cancer at a general hospital in Japan [J]. Hepatogastroenterology, 2005, 52(61): 293297.
3.	Dulucq JL, Wintringer P, Stabilini C, et al. Laparoscopic and open gastric resections for malignant lesions: a prospective comparative study [J]. Surg Endosc, 2005, 19(7): 933938.
4.	Lee JH, Yom CK, Han HS. Comparison of longterm outcomes of laparoscopyassisted and open distal gastrectomy for early gastric cancer [J]. Surg Endosc, 2009, 23(8): 17591763.
5.	Hwang SI, Kim HO, Yoo CH, et al. Laparoscopicassisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer [J]. Surg Endosc, 2009, 23(6): 12521258.
6.	Japan Society for Endoscopic Surgery. Nationwide survey on endoscopic surgery in Japan [J]. J Jpn Soc Endosc Surg, 2004, 9(7): 495500.
7.	Japan Society for Endoscopic Surgery. Nationwide survey on endoscopic surgery in Japan [J]. J Jpn Soc Endosc Surg, 2008, 5(5): 525529.
8.	郑民华, 臧潞. 腹腔镜外科治疗早期胃癌的现状 [J]. 内科理论与实践, 2010, 5(3): 203206.
9.	Goh PM, Khan AZ, So JB, et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer [J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 8387.
10.	Sarela AI. Entirely laparoscopic radical gastrectomy for adenocarcinoma: lymph node yield and resection margins [J]. Surg Endosc, 2009, 23(1): 153160.
11.	Japanese Gastric Cancer Association. Guidelines for the treatment of gastric cancer [M]. 2nd. Eds. Tokyo: Kanehara, 2004: 4042.
12.	Japanese Gastric Cancer Association. Guidelines for the treatment of gastric cancer [M]. 3rd. Eds. Tokyo: Kanehara, 2010: 3031.
13.	胡祥. 日本《胃癌治疗指南》(第3版)解读 [J]. 中国实用外科杂志, 2010, 30(1): 2530.
14.	余佩武. 胃癌腹腔镜手术现状 [J]. 临床外科杂志, 2008, 16(10): 654656.
15.	Ly QP, Sasson AR. Modern surgical considerations for gastric cancer [J]. J Natl Compr Netw, 2008, 6(9): 885894.
16.	Memon MA, Khan S, Yunus RM, et al. Metaanalysis of laparoscopic and open distal gastr ectomy for gastric carcinoma [J]. Surg Endosc, 2008, 22(8): 17811789.
17.	Park JM, Jin SH, Lee SR, et al. Complications with laparoscopically assisted gastrectomy: multivariate analysis of 300 consecutive cases [J]. Surg Endosc, 2008, 22(10): 21332139.
18.	余佩武. 腹腔镜胃癌根治术的原则与评价 [J]. 中国普外基础与临床杂志, 2009, 16(1): 15.
19.	Lee JH, Han HS, Lee JH. A prospective randomized study comparing open vs laparoscopyassisted distal gastrectomy in early gastric cancer: early results [J]. Surg Endosc, 2005, 19(2): 168173.
20.	Weber KJ, Reyes CD, Gagner M, et al. Comparison of laparoscopic and open gastrectomy for malignant disease [J]. Surg Endosc, 2003, 17(6): 968971.
21.	Lee SI, Choi YS, Park DJ, et al. Comparative study of laparoscopyassisted distal gastrectomy and open distal gastrectomy [J]. J Am Coll Surg, 2006, 202(6): 874880.
22.	Tanimura S, Higashino M, Fukunaga Y, et al. Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases [J]. Surg Endosc, 2008, 22(5): 11611164.
23.	Huscher CG, Mingoli A, Sgarzini G, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: fiveyear results of a randomized prospective trial [J]. Ann Surg, 2005, 241(2): 232237.
24.	Hosono S, Arimoto Y, Ohtani H, et al. Metaanalysis of shortterm outcomes after laparoscopicassisted distal gastrectomy [J]. World J Gastroenterol, 2006, 12(47): 76767683.
25.	Kim HH, Hyung WJ, Cho GS, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report-a phase Ⅲ multicenter, prospective, randomized Trial (KLASS Trial) [J]. Ann Surg, 2010, 251(3): 417420.
26.	余佩武, 钱锋, 罗华星, 等. 腹腔镜胃癌根治术的临床疗效 [J]. 中华消化外科杂志, 2008, 7(1): 3840.
27.	Kitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan [J]. Ann Surg, 2007, 245(1): 6872.
28.	臧潞, 胡伟国, 李佑, 等. 腹腔镜早期胃癌根治术后临床研究 [J]. 内科理论与实践, 2010, 5(3): 210213.
29.	Ryu KW, Kim YW, Lee JH, et al. Surgical complications and the risk factors of laparoscopyassisted distal gastrectomy in early gastric cancer [J]. Ann Surg Oncol, 2008, 15(6): 16251631.
30.	钱峻, 汤黎明, 朱杰, 等. 腹腔镜胃癌根治手术中的团队配合 [J]. 中国微创外科杂志, 2009, 9(9): 781783.
31.	吴涛, 李国新, 丁自海, 等. 腹腔镜下远端胃癌根治术中胃背系膜及系膜间隙的解剖形态特点 [J]. 中国临床解剖学杂志, 2007, 25(3): 251254.
32.	Ogura G, Nakamura R, Muragaki Y, et al. Development of an articulating ultrasonically activated device for laparoscopic surgery [J]. Surg Endosc, 2009, 23(9): 21382142.
33.	Oz BS, Mataraci I, Iyem H, et al. Comparison of ultrasonically activated scalpel and traditional technique in radical artery harvesting: clinical research [J]. Thorac Cardiovasc Surg, 2007, 55(2): 104107.
34.	郑勇斌, 童仕伦, 谭海燕, 等. 超声刀在腹腔镜胃癌根治手术中的应用 [J]. 中国普外基础与临床杂志, 2009, 16(10): 781784.
35.	Tokunaga M, Hiki N, Fukunaga T, et al. Quality control and educational value of laparoscopyassisted gastrectomy in a highvolume center [J]. Surg Endosc, 2009, 23(2): 289291.
36.	Pugliese R, Maggioni D, Sansonna F, et al. Total and subtotal laparoscopic gastrectomy for adenocarcinoma [J]. Surg Endosc, 2007, 21(1): 2127.
37.	Lee JH, Kim YW, Ryu KW, et al. A phaseⅡ clinical trial of laparoscopyassisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients [J]. Ann Surg Oncol, 2007, 14(11): 31483153.
38.	Hao YX, Yu PW, Zhong H, et al. Comparison of laparoscopic and open gastrectomy on cancer cells exfoliating from the cancerinvaded serosa [J]. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): 201207.
39.	陈凛. 腹腔镜胃癌根治术后并发症的预防及处理　 [J/OL]. 中华普外科手术学杂志(电子版), 2008, 2(1): 2627.
40.	李佑, 王明亮. 早期胃癌的腹腔镜手术治疗进展　 [J/OL]. 中华腔镜外科杂志(电子版), 2008, 1(2): 119122.
41.	Varela JE, Hiyashi M, Nguyen T, et al. Comparison of laparoscopic and open gastrectomy for gastric cancer [J]. Am J Surg, 2006, 192(6): 837842.
42.	松井英男. 食道空腸顺蠕动側側吻合口法(胃全摘後 RouxenY食道空腸側側吻合) [J]. 手術, 2010, 64(10): 14551460.

1. Kitano S, Iso Y, Moriyama M, et al. Laparoscopyassisted Billroth Ⅰ gastrectomy [J]. Surg Laparosc Endosc, 1994, 4(2): 146148.
2. Naka T, Ishikura T, Shibata S, et al. Laparoscopyassisted and open distal gastrectomies for early gastric cancer at a general hospital in Japan [J]. Hepatogastroenterology, 2005, 52(61): 293297.
3. Dulucq JL, Wintringer P, Stabilini C, et al. Laparoscopic and open gastric resections for malignant lesions: a prospective comparative study [J]. Surg Endosc, 2005, 19(7): 933938.
4. Lee JH, Yom CK, Han HS. Comparison of longterm outcomes of laparoscopyassisted and open distal gastrectomy for early gastric cancer [J]. Surg Endosc, 2009, 23(8): 17591763.
5. Hwang SI, Kim HO, Yoo CH, et al. Laparoscopicassisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer [J]. Surg Endosc, 2009, 23(6): 12521258.
6. Japan Society for Endoscopic Surgery. Nationwide survey on endoscopic surgery in Japan [J]. J Jpn Soc Endosc Surg, 2004, 9(7): 495500.
7. Japan Society for Endoscopic Surgery. Nationwide survey on endoscopic surgery in Japan [J]. J Jpn Soc Endosc Surg, 2008, 5(5): 525529.
8. 郑民华, 臧潞. 腹腔镜外科治疗早期胃癌的现状 [J]. 内科理论与实践, 2010, 5(3): 203206.
9. Goh PM, Khan AZ, So JB, et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer [J]. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 8387.
10. Sarela AI. Entirely laparoscopic radical gastrectomy for adenocarcinoma: lymph node yield and resection margins [J]. Surg Endosc, 2009, 23(1): 153160.
11. Japanese Gastric Cancer Association. Guidelines for the treatment of gastric cancer [M]. 2nd. Eds. Tokyo: Kanehara, 2004: 4042.
12. Japanese Gastric Cancer Association. Guidelines for the treatment of gastric cancer [M]. 3rd. Eds. Tokyo: Kanehara, 2010: 3031.
13. 胡祥. 日本《胃癌治疗指南》(第3版)解读 [J]. 中国实用外科杂志, 2010, 30(1): 2530.
14. 余佩武. 胃癌腹腔镜手术现状 [J]. 临床外科杂志, 2008, 16(10): 654656.
15. Ly QP, Sasson AR. Modern surgical considerations for gastric cancer [J]. J Natl Compr Netw, 2008, 6(9): 885894.
16. Memon MA, Khan S, Yunus RM, et al. Metaanalysis of laparoscopic and open distal gastr ectomy for gastric carcinoma [J]. Surg Endosc, 2008, 22(8): 17811789.
17. Park JM, Jin SH, Lee SR, et al. Complications with laparoscopically assisted gastrectomy: multivariate analysis of 300 consecutive cases [J]. Surg Endosc, 2008, 22(10): 21332139.
18. 余佩武. 腹腔镜胃癌根治术的原则与评价 [J]. 中国普外基础与临床杂志, 2009, 16(1): 15.
19. Lee JH, Han HS, Lee JH. A prospective randomized study comparing open vs laparoscopyassisted distal gastrectomy in early gastric cancer: early results [J]. Surg Endosc, 2005, 19(2): 168173.
20. Weber KJ, Reyes CD, Gagner M, et al. Comparison of laparoscopic and open gastrectomy for malignant disease [J]. Surg Endosc, 2003, 17(6): 968971.
21. Lee SI, Choi YS, Park DJ, et al. Comparative study of laparoscopyassisted distal gastrectomy and open distal gastrectomy [J]. J Am Coll Surg, 2006, 202(6): 874880.
22. Tanimura S, Higashino M, Fukunaga Y, et al. Laparoscopic gastrectomy for gastric cancer: experience with more than 600 cases [J]. Surg Endosc, 2008, 22(5): 11611164.
23. Huscher CG, Mingoli A, Sgarzini G, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: fiveyear results of a randomized prospective trial [J]. Ann Surg, 2005, 241(2): 232237.
24. Hosono S, Arimoto Y, Ohtani H, et al. Metaanalysis of shortterm outcomes after laparoscopicassisted distal gastrectomy [J]. World J Gastroenterol, 2006, 12(47): 76767683.
25. Kim HH, Hyung WJ, Cho GS, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report-a phase Ⅲ multicenter, prospective, randomized Trial (KLASS Trial) [J]. Ann Surg, 2010, 251(3): 417420.
26. 余佩武, 钱锋, 罗华星, 等. 腹腔镜胃癌根治术的临床疗效 [J]. 中华消化外科杂志, 2008, 7(1): 3840.
27. Kitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan [J]. Ann Surg, 2007, 245(1): 6872.
28. 臧潞, 胡伟国, 李佑, 等. 腹腔镜早期胃癌根治术后临床研究 [J]. 内科理论与实践, 2010, 5(3): 210213.
29. Ryu KW, Kim YW, Lee JH, et al. Surgical complications and the risk factors of laparoscopyassisted distal gastrectomy in early gastric cancer [J]. Ann Surg Oncol, 2008, 15(6): 16251631.
30. 钱峻, 汤黎明, 朱杰, 等. 腹腔镜胃癌根治手术中的团队配合 [J]. 中国微创外科杂志, 2009, 9(9): 781783.
31. 吴涛, 李国新, 丁自海, 等. 腹腔镜下远端胃癌根治术中胃背系膜及系膜间隙的解剖形态特点 [J]. 中国临床解剖学杂志, 2007, 25(3): 251254.
32. Ogura G, Nakamura R, Muragaki Y, et al. Development of an articulating ultrasonically activated device for laparoscopic surgery [J]. Surg Endosc, 2009, 23(9): 21382142.
33. Oz BS, Mataraci I, Iyem H, et al. Comparison of ultrasonically activated scalpel and traditional technique in radical artery harvesting: clinical research [J]. Thorac Cardiovasc Surg, 2007, 55(2): 104107.
34. 郑勇斌, 童仕伦, 谭海燕, 等. 超声刀在腹腔镜胃癌根治手术中的应用 [J]. 中国普外基础与临床杂志, 2009, 16(10): 781784.
35. Tokunaga M, Hiki N, Fukunaga T, et al. Quality control and educational value of laparoscopyassisted gastrectomy in a highvolume center [J]. Surg Endosc, 2009, 23(2): 289291.
36. Pugliese R, Maggioni D, Sansonna F, et al. Total and subtotal laparoscopic gastrectomy for adenocarcinoma [J]. Surg Endosc, 2007, 21(1): 2127.
37. Lee JH, Kim YW, Ryu KW, et al. A phaseⅡ clinical trial of laparoscopyassisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients [J]. Ann Surg Oncol, 2007, 14(11): 31483153.
38. Hao YX, Yu PW, Zhong H, et al. Comparison of laparoscopic and open gastrectomy on cancer cells exfoliating from the cancerinvaded serosa [J]. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): 201207.
39. 陈凛. 腹腔镜胃癌根治术后并发症的预防及处理　 [J/OL]. 中华普外科手术学杂志(电子版), 2008, 2(1): 2627.
40. 李佑, 王明亮. 早期胃癌的腹腔镜手术治疗进展　 [J/OL]. 中华腔镜外科杂志(电子版), 2008, 1(2): 119122.
41. Varela JE, Hiyashi M, Nguyen T, et al. Comparison of laparoscopic and open gastrectomy for gastric cancer [J]. Am J Surg, 2006, 192(6): 837842.
42. 松井英男. 食道空腸顺蠕动側側吻合口法(胃全摘後 RouxenY食道空腸側側吻合) [J]. 手術, 2010, 64(10): 14551460.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Management and Prophylaxis of Complications in Laparoscopic Gastrectomy

Abstract Full text Figures/Tables Video References Cited by

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