Postoperative complication rates and invasiveness of laparoscopy-assisted distal gastrectomy and open distal gastrectomy based on the American Society of Anesthesiologists classification system.
BACKGROUND
We investigated potential advantages of laparoscopy-assisted distal gastrectomy (LADG) in high-risk gastric cancer patients. We examined the differences among various risk groups by comparing the incidence of postoperative complications and invasiveness of LADG with those of open distal gastrectomy (ODG) based on the American Society of Anesthesiologists (ASA) criteria.


METHODS
A total of 639 patients with stage IA or IB gastric cancer were included in this study. ODG was performed between 2003 and 2005, and LADG was performed between 2006 and 2011.


RESULTS
The incidence of postoperative complications in the LADG group (ASA1, 5.6%; ASA2, 3.8%; and ASA3, 5.7%) was significantly lower than that in the ODG group in all the ASA classes (ASA1, 16.9%; ASA2, 12.5%; and ASA3, 20%). Changes in the pain scores, body temperatures and blood analyses revealed that LADG was less invasive than ODG in all ASA classes. However, as the ASA class increased, the less invasive nature of LADG decreased.


CONCLUSIONS
LADG may be less invasive than ODG, even in ASA3 patients. Hence, LADG may reduce the incidence of postoperative complications in ASA1, ASA2, and ASA3 patients.
Department of Surgery, JA Sapporo Kosei Hospital, Sapporo, Japan. h.kawamura@ja-hokkaidoukouseiren.or.jp
Hideki
H
Kawamura
Toshiro
T
Tanioka
Munenori
M
Tahara
Masahiro
M
Takahashi
D000368:Aged; D000776:Anesthesiology; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012955:Societies, Medical; D013274:Stomach Neoplasms / Q000145:classification / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014481:United States
ASA classification; gastrectomy; laparoscopy