title: Major early complications following open, laparoscopic and robotic gastrectomy.
abstract: BACKGROUND
  Laparoscopic and robotic gastrectomy have been adopted rapidly despite lack of evidence concerning technical safety and controversy regarding additional benefits. This study aimed to compare clinically relevant complications after open, laparoscopic and robotic gastrectomy.
  
  
  METHODS
  This was a retrospective analysis of prospectively collected data on surgical complications in patients undergoing gastrectomy with curative intent for histologically proven adenocarcinoma between 2005 and 2010 at the Department of Surgery, Yonsei University College of Medicine in Seoul, Korea. Complications were categorized into wound infection, bleeding, anastomotic leak, obstruction, fluid collection and other.
  
  
  RESULTS
  In a total of 5839 patients (4542 open, 861 laparoscopic and 436 robotic gastrectomies), overall complication, reoperation and mortality rates were 10·5, 1·0 and 0·4 per cent respectively. There were no significant differences between the three groups. Ileus (P = 0·001) and intra-abdominal fluid collections (P = 0·013) were commoner after conventional open surgery. However, tumour stage was higher and more complex resections were performed in the open group. Anastomotic leak, the leading cause of death, occurred more often after a minimally invasive approach (P = 0·017).
  
  
  CONCLUSIONS
  Laparoscopic and robotic gastrectomy had overall complication and mortality rates similar to those of open surgery, but anastomotic leaks were more common with the minimally invasive techniques.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seongsanno, Seodaemun-gu, Seoul, Korea.
authors.forename: K M
authors.initials: KM
authors.lastname: Kim
authors.forename: J Y
authors.initials: JY
authors.lastname: An
authors.forename: H I
authors.initials: HI
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Cheong
authors.forename: W J
authors.initials: WJ
authors.lastname: Hyung
authors.forename: S H
authors.initials: SH
authors.lastname: Noh
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000230:Adenocarcinoma / Q000601:surgery*; D000704:Analysis of Variance; D057868:Anastomotic Leak / Q000209:etiology; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D045823:Ileus / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies; D012371:Robotics; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome