Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: A large-scale Korean multicenter study

Min Chan Kim, Wook Kim, Hyung Ho Kim, Seung Wan Ryu, Seong Yeob Ryu, Kyo Young Song, Hyuk Joon Lee, Gyu Seok Cho, Sang Uk Han, Woo Jin Hyung

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Abstract

Background: The aim of this multicenter retrospective study was to establish background data for future randomized clinical trial comparing open and laparoscopy-assisted gastrectomies (LAGs). We sought to evaluate the technical feasibility of LAG by determining the morbidity and mortality and identifying corresponding predictive factors. Patients and Methods: A retrospective multicenter study was carried out in Korea on 1,485 patients in who, LAG had been attempted for gastric cancer under the care of ten surgeons, at ten institutions, during the period spanning May 1998 to December 2005. Patient characteristics, operative outcomes, and postoperative morbidities and mortalities were analyzed. Results: Overall morbidity and mortality rates were 14.0% and 0.6%, respectively. Complications included: wound problem (4.2%, n = 62), intraluminal bleeding (1.3%, n = 20), intra-abdominal abscess or fluid collection (1.3%, n = 19), anastomotic leakage (1.3%, n = 18), and intra-abdominal bleeding (1.3%, n = 18). By using multivariate analysis we found that the two most important risk factors associated with postoperative complications were presence of comorbidity in the patient and lack of experience on the part of the surgeon. Conclusion: LAG is a technically feasible, safe, and effective method for treating patients with gastric cancer. Extra caution in patients with comorbidities, and dedication to improving surgical proficiency in LAG, may decrease the risk of complications. Through this study, we have established the inclusion criteria for LAG. For our multicenter, prospective, randomized trials (NCT00452751), potential patients should have an American Society of Anesthesiology (ASA) score of less than 3, and surgeons performing the procedures should have experience with more than 50 cases of LAG.

Original languageEnglish
Pages (from-to)2692-2700
Number of pages9
JournalAnnals of Surgical Oncology
Volume15
Issue number10
DOIs
Publication statusPublished - 2008 Oct 1

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Gastrectomy
Laparoscopy
Multicenter Studies
Stomach Neoplasms
Morbidity
Mortality
Comorbidity
Retrospective Studies
Hemorrhage
Abdominal Abscess
Anastomotic Leak
Anesthesiology
Anniversaries and Special Events
Korea
Multivariate Analysis
Randomized Controlled Trials
Wounds and Injuries
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, Min Chan ; Kim, Wook ; Kim, Hyung Ho ; Ryu, Seung Wan ; Ryu, Seong Yeob ; Song, Kyo Young ; Lee, Hyuk Joon ; Cho, Gyu Seok ; Han, Sang Uk ; Hyung, Woo Jin. / Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer : A large-scale Korean multicenter study. In: Annals of Surgical Oncology. 2008 ; Vol. 15, No. 10. pp. 2692-2700.
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abstract = "Background: The aim of this multicenter retrospective study was to establish background data for future randomized clinical trial comparing open and laparoscopy-assisted gastrectomies (LAGs). We sought to evaluate the technical feasibility of LAG by determining the morbidity and mortality and identifying corresponding predictive factors. Patients and Methods: A retrospective multicenter study was carried out in Korea on 1,485 patients in who, LAG had been attempted for gastric cancer under the care of ten surgeons, at ten institutions, during the period spanning May 1998 to December 2005. Patient characteristics, operative outcomes, and postoperative morbidities and mortalities were analyzed. Results: Overall morbidity and mortality rates were 14.0{\%} and 0.6{\%}, respectively. Complications included: wound problem (4.2{\%}, n = 62), intraluminal bleeding (1.3{\%}, n = 20), intra-abdominal abscess or fluid collection (1.3{\%}, n = 19), anastomotic leakage (1.3{\%}, n = 18), and intra-abdominal bleeding (1.3{\%}, n = 18). By using multivariate analysis we found that the two most important risk factors associated with postoperative complications were presence of comorbidity in the patient and lack of experience on the part of the surgeon. Conclusion: LAG is a technically feasible, safe, and effective method for treating patients with gastric cancer. Extra caution in patients with comorbidities, and dedication to improving surgical proficiency in LAG, may decrease the risk of complications. Through this study, we have established the inclusion criteria for LAG. For our multicenter, prospective, randomized trials (NCT00452751), potential patients should have an American Society of Anesthesiology (ASA) score of less than 3, and surgeons performing the procedures should have experience with more than 50 cases of LAG.",
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Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer : A large-scale Korean multicenter study. / Kim, Min Chan; Kim, Wook; Kim, Hyung Ho; Ryu, Seung Wan; Ryu, Seong Yeob; Song, Kyo Young; Lee, Hyuk Joon; Cho, Gyu Seok; Han, Sang Uk; Hyung, Woo Jin.

In: Annals of Surgical Oncology, Vol. 15, No. 10, 01.10.2008, p. 2692-2700.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer

T2 - A large-scale Korean multicenter study

AU - Kim, Min Chan

AU - Kim, Wook

AU - Kim, Hyung Ho

AU - Ryu, Seung Wan

AU - Ryu, Seong Yeob

AU - Song, Kyo Young

AU - Lee, Hyuk Joon

AU - Cho, Gyu Seok

AU - Han, Sang Uk

AU - Hyung, Woo Jin

PY - 2008/10/1

Y1 - 2008/10/1

N2 - Background: The aim of this multicenter retrospective study was to establish background data for future randomized clinical trial comparing open and laparoscopy-assisted gastrectomies (LAGs). We sought to evaluate the technical feasibility of LAG by determining the morbidity and mortality and identifying corresponding predictive factors. Patients and Methods: A retrospective multicenter study was carried out in Korea on 1,485 patients in who, LAG had been attempted for gastric cancer under the care of ten surgeons, at ten institutions, during the period spanning May 1998 to December 2005. Patient characteristics, operative outcomes, and postoperative morbidities and mortalities were analyzed. Results: Overall morbidity and mortality rates were 14.0% and 0.6%, respectively. Complications included: wound problem (4.2%, n = 62), intraluminal bleeding (1.3%, n = 20), intra-abdominal abscess or fluid collection (1.3%, n = 19), anastomotic leakage (1.3%, n = 18), and intra-abdominal bleeding (1.3%, n = 18). By using multivariate analysis we found that the two most important risk factors associated with postoperative complications were presence of comorbidity in the patient and lack of experience on the part of the surgeon. Conclusion: LAG is a technically feasible, safe, and effective method for treating patients with gastric cancer. Extra caution in patients with comorbidities, and dedication to improving surgical proficiency in LAG, may decrease the risk of complications. Through this study, we have established the inclusion criteria for LAG. For our multicenter, prospective, randomized trials (NCT00452751), potential patients should have an American Society of Anesthesiology (ASA) score of less than 3, and surgeons performing the procedures should have experience with more than 50 cases of LAG.

AB - Background: The aim of this multicenter retrospective study was to establish background data for future randomized clinical trial comparing open and laparoscopy-assisted gastrectomies (LAGs). We sought to evaluate the technical feasibility of LAG by determining the morbidity and mortality and identifying corresponding predictive factors. Patients and Methods: A retrospective multicenter study was carried out in Korea on 1,485 patients in who, LAG had been attempted for gastric cancer under the care of ten surgeons, at ten institutions, during the period spanning May 1998 to December 2005. Patient characteristics, operative outcomes, and postoperative morbidities and mortalities were analyzed. Results: Overall morbidity and mortality rates were 14.0% and 0.6%, respectively. Complications included: wound problem (4.2%, n = 62), intraluminal bleeding (1.3%, n = 20), intra-abdominal abscess or fluid collection (1.3%, n = 19), anastomotic leakage (1.3%, n = 18), and intra-abdominal bleeding (1.3%, n = 18). By using multivariate analysis we found that the two most important risk factors associated with postoperative complications were presence of comorbidity in the patient and lack of experience on the part of the surgeon. Conclusion: LAG is a technically feasible, safe, and effective method for treating patients with gastric cancer. Extra caution in patients with comorbidities, and dedication to improving surgical proficiency in LAG, may decrease the risk of complications. Through this study, we have established the inclusion criteria for LAG. For our multicenter, prospective, randomized trials (NCT00452751), potential patients should have an American Society of Anesthesiology (ASA) score of less than 3, and surgeons performing the procedures should have experience with more than 50 cases of LAG.

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