Laparoscopy-assisted distal gastrectomy for gastric cancer patients with comorbid diseases: is it contraindicated for patients with systemic comorbidity?

Background: This study was carried out to evaluate the safety and feasibility of laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer patients with systemic comorbidity.Materials and Methods: Two hundred and seventy-six patients who had undergone LADG by a single surgeon were given a ph...

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Published in:Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Vol. 21; no. 1; pp. 33 - 37
Main Authors: Choi, Yoo Shin, Park, Do Joong, Lee, Hyuk-Joon, Kim, Hyung-Ho, Yang, Han-Kwang, Lee, Kuhn Uk
Format: research tables/charts Journal Article
Published: Lippincott Williams & Wilkins 2011 Feb
Online Access:View this record in EBSCOhost
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      dt: 2011 Feb
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/SLE.0b013e3182050c47
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        atl: Laparoscopy-assisted distal gastrectomy for gastric cancer patients with comorbid diseases: is it contraindicated for patients with systemic comorbidity?
      aug:
        au:
          Choi, Yoo Shin
          Park, Do Joong
          Lee, Hyuk-Joon
          Kim, Hyung-Ho
          Yang, Han-Kwang
          Lee, Kuhn Uk
        affil: *Department of Surgery, College of Medicine, Chung-Ang University tDepartment of Surgery, Seoul National University College of Medicine, Seoul tDepartment of Surgery, Seoul National University Bundang Hospital, Gyeonggi, Korea.
      sug:
        subj:
          Comorbidity
          Risk Assessment
          Stomach Neoplasms Surgery
          Surgery, Laparoscopic Methods
          Treatment Outcomes
          Adult
          Aged
          Chi Square Test
          Data Analysis Software
          Descriptive Statistics
          Female
          Human
          South Korea
          Male
          Middle Age
          Quality of Life
          Retrospective Design
          Survival
          T-Tests
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: This study was carried out to evaluate the safety and feasibility of laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer patients with systemic comorbidity.Materials and Methods: Two hundred and seventy-six patients who had undergone LADG by a single surgeon were given a physical status classification as defined by the American Society of Anesthesiologists (ASA class) and then divided into 2 criteria groups: criteria I group (ASA 1 vs ASA 2,3,4) and criteria II group (ASA 1,2 vs ASA 3,4). The clinicopathologic data of each patient were reviewed retrospectively and grouped by criteria.Results: The percentage of patients with a comorbid disease was 8.1% (11 cases) in ASA class 1, 71.7% (86 cases) in class 2, 95.0% (19 cases) in class 3, and 100% (1 case) in class 4. No statistical difference was found between criteria I and II in terms of operative and postoperative results, operative time, estimated blood loss, transfusion rate, tumor size, total and positive number of dissected lymph nodes, proximal resection margin from lesion, the rate of open conversion, the duration of hospital stay, the time required before resuming a liquid diet, and the rate of complications, except the distal resection margin in criteria II (all P >0.05). There were no cases of mortality in any criteria group.Conclusions: LADG would be a safe and feasible operation for patients with gastric cancer with systemic comorbidity, without reducing radicality, losing the advantages of minimally invasive surgery, or increasing operative risk.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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