title: Results of laparoscopic gastrectomy for early gastric cancer in high-risk patients - estimation of surgical risk of gastrectomy.
abstract: OBJECTIVE
  Surgical risk of laparoscopic gastrectomy for gastric cancer in high risk patients was evaluated with E-PASS scoring system.
  
  
  METHODS
  This study was based on 63 patients with gastric cancer who underwent laparoscopic gastrectomy; 14 patients belonging to high risk group (ASA≥3) and 49 classified as low risk group (ASA≤2). Fifty six patients who underwent conventional gastrectomy were used for comparison.
  
  
  RESULTS
  Intra- and postoperative complications were found in 4 and 3 of 14 high risk patients, respectively. We found a significant correlation between E-PASS score and complications. E-PASS score in high risk group was significantly higher than the value in low risk group. The estimated in-hospital mortality rate was significantly different between the two groups. When conventional gastrectomy group for high risk patients was compared, postoperative morbidity and mortality rates were similar in two surgical procedures; however E-PASS score and the estimated in-hospital mortality rate with conventional gastrectomy were significantly higher than the value with laparoscopic gastrectomy.
  
  
  CONCLUSIONS
  There were no fatal complications in high risk patients with laparoscopic gastrectomy and E-PASS score was within safety margin. Extension of laparoscopic surgery in high risk patients was feasible when careful procedure was performed by a surgical team.
authors: Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan. sprinter6369@yahoo.co.jp
authors: Kenichi
authors: K
authors: Koushi
authors: Daisuke
authors: D
authors: Korenaga
authors: Ai
authors: A
authors: Edagawa
authors: Hirofumi
authors: H
authors: Kawanaka
authors: Toshirou
authors: T
authors: Okuyama
authors: Akinori
authors: A
authors: Egashira
authors: Masahiro
authors: M
authors: Tateishi
authors: Kenji
authors: K
authors: Takenaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000601:surgery*