Analysis Of Risk Factor For Post Operative Complications And Long Term Outcome After Laparoscopic Assisted Distal Gastrectomy For Gastric Cancer

Objective: The aim of this study was to identify risk factors for post operative complications and prognostic factor for long term survival following laparoscopic assisted distal gastrectomy(LADG) for gastric cancer.Methods: We collected data retrospectively from 228 patients who underwent LADG with lymph node dissection(LND) for gastric cancer between January 2004 and December 2011 in our department.Patients were followed up until December 2013. The risk factors for postoperative complications and overall survival of LADG were evaluated and analyzed.Results: During the time period, 312 operations were performed for gastric cancer. Among them, 297 cases had undergone radical resection while palliative surgery was performed for rest 15 cases and a total of 228 cases were done by LADG(72.8%). In univariate analysis of overall postoperative complications, there were significant effects of higher age(above 70 years), lymph node metastasis and type of procedure(Billroth I vs others). Multivariate analysis of these risk factors showed that old age(>70 years)(P =.017), and type of procedure(P= 0.013) were independent risk factors for postoperative complications. Similarly, in univariate analysis of overall survival Pathological stage, LN metastasis, depth of invasion, size of lesion, Type of procedure, intraoperative bleeding, operation time, extent of lymph node dissection and histopathology of specimen had significant effect but status of LN metastasis(0.002) and Histopathology; undifferentiated(0.027) were found to be the only independent factors in multivariate analysis.Conclusion: Higher age, and type of anastomotic procedure other than B-I are independent risk factors for postoperative complications. Lymph node metastasis and undifferentiated tumor were found to be independent risk factors for overall survival after LADG. Though laparoscopy assisted procedures seems to be feasible for management of gastric cancer, risk of these factors has to be considered while planning LADG for individual gastric cancer patients.