title: Laparoscopic gastrectomy for patients with a history of upper abdominal surgery: results of a matched-pair analysis.
abstract: OBJECTIVE
  The safety and feasibility of laparoscopic gastrectomy (LG) for patients who have undergone previous upper abdominal surgery (PUAS) remain unclear. A matched-pair analysis was conducted to compare the short-term outcomes of LG between patients with gastric cancer who had undergone PUAS and those who had not.
  
  
  METHODS
  A matched-pair analysis was performed to compare the short-term outcomes of LG between 22 patients who had undergone PUAS and 66 who had not (control group). To compare the outcome to that of open gastrectomy (OG) following PUAS, a total of 143 consecutive OG patients treated during the same study period were also reviewed.
  
  
  RESULTS
  Cholecystectomy was the most common type of PUAS, followed by gastrectomy. There were no significant differences between the groups in terms of the length of the operation, blood loss, and the number of retrieved lymph nodes or the rate of conversion to open surgery. The postoperative morbidity in the PUAS group (3/22, 13.6 %) was comparable to that of the control group (7/66, 10.6 %, P = 0.6981). There was no mortality within 30 days in either group. When compared to OG following PUAS (n = 23), LG was performed with significantly less blood loss with an equivalent postoperative outcome.
  
  
  CONCLUSIONS
  LG following PUAS is considered to be a safe and feasible surgical modality. PUAS should therefore not be regarded as a contraindication for LG.
authors: Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors: Shigeru
authors: S
authors: Tsunoda
authors: Hiroshi
authors: H
authors: Okabe
authors: Kazutaka
authors: K
authors: Obama
authors: Eiji
authors: E
authors: Tanaka
authors: Masatoshi
authors: M
authors: Akagami
authors: Yousuke
authors: Y
authors: Kinjo
authors: Yoshiharu
authors: Y
authors: Sakai
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D003082:Colectomy; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009392:Nephrectomy; D010180:Pancreatectomy; D012449:Safety; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome