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KMID : 0914820130130040207
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Journal of the Korean Gastric Cancer Association
2013 Volume.13 No. 4 p.207 ~ p.213
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Is Laparoscopy-assisted Radical Gastrectomy Safe in Patients with Child-Pugh Class A Cirrhosis?
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Kang Sin-Jae
Jung Mi-Ran
Cheong Oh
Park Young-Kyu
Kim Ho-Goon
Kim Dong-Yi
Kim Hoi-Won
Ryu Seong-Yeob
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Abstract
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Purpose: We investigated early postoperative morbidity and mortality in patients with liver cirrhosis who had undergone radical gastrectomyfor gastric cancer.
Materials and Methods: We retrospectively reviewed the medical records of 41 patients who underwent radical gastrectomy at the Chonnam National University Hwasun Hospital (Hwasun-gun, Korea) between August 2004 and June 2009. There were few patients with Child-Pugh class B or C; therefore, we restricted patient selection to those with Child-Pugh class A.
Results: Postoperative complications were observed in 22 (53.7%) patients. The most common complications were ascites (46.3%), postoperative hemorrhage (22.0%) and wound infection (12.2%). Intra-abdominal abscess developed in one (2.4%) patient who had undergone open gastrectomy. Massive ascites occurred in 4 (9.8%) patients. Of the patients who underwent open gastrectomy, nine (21.9%) patients required blood transfusions as a result of postoperative hemorrhage. However, most of these patients had advanced gastric cancer. In contrast, most patients who underwent laparoscopic gastrectomy had early stage gastric cancer, and when the confoundingeffect from the different stages between the two groups was corrected statistically, no statistically significant difference was found. There was also no significant difference between open and laparoscopic gastrectomy in the occurrence rate of other postoperative complications such as ascites, wound infection, and intra-abdominal abscess. No postoperative mortality occurred.
Conclusions:Laparoscopic gastrectomy is a feasible surgical procedure for patients with moderate hepatic dysfunction.
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KEYWORD
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Stomach neoplasms, Liver cirrhosis, Gastrectomy
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