title: Clinical outcomes of laparoscopy-assisted gastrectomy for patients with heart disease.
abstract: Laparoscopy-assisted gastrectomy (LG) is an established treatment for early gastric cancer. However, CO2 pneumoperitoneum during laparoscopic surgery can adversely affect cardiac function in the presence of heart disease (HD). We performed LG in 546 patients and conventional open gastrectomy (OG) in 448 patients. Patients with preoperatively diagnosed and treated HD were identified. The clinical outcomes of patients with HD who underwent LG (HD-LG) were compared with those of patients with HD who underwent OG (HD-OG), as well as those of patients with no operative risk who underwent LG (NR-LG). Variables of cardiac function were similar in the HD-LG and HD-OG groups. Postoperative cardiac complications did not differ between the groups (8.3% vs. 13.6%, P = 0.51). The HD-LG group had significantly more cardiac and abdominal complications than the NR-LG group (P = 0.0011 and 0.0070, respectively). LG was tolerated in patients with gastric cancer and mild or moderate HD, similar to OG.
authors: Department of Esophagogastric Surgery, Tokyo Medical and Dental University, Tokyo, Japan. m-inokuchi.srg2@tmd.ac.jp
authors: Mikito
authors: M
authors: Inokuchi
authors: Kazuyuki
authors: K
authors: Kojima
authors: Hiroyuki
authors: H
authors: Yamada
authors: Keiji
authors: K
authors: Kato
authors: Megumu
authors: M
authors: Enjoji
authors: Mikiko
authors: M
authors: Hayashi
authors: Kazuo
authors: K
authors: Motoyama
authors: Kenichi
authors: K
authors: Sugihara
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*