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Relationship between laparoscopic total gastrectomy-associated postoperative complications and gastric cancer prognosis

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Title: Relationship between laparoscopic total gastrectomy-associated postoperative complications and gastric cancer prognosis
Authors: Ebihara, Yuma Browse this author →KAKEN DB
Kyogoku, Noriaki Browse this author
Murakami, Yoshihiro Browse this author
Murakawa, Katsuhiko Browse this author
Nakamura, Fumitaka Browse this author
Morita, Takayuki Browse this author
Okushiba, Shunichi Browse this author
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Laparoscopic total gastrectomy
Gastric cancer
Postoperative complications
Overall survival
Issue Date: 1-Jan-2023
Publisher: Springer
Journal Title: Updates in surgery
Volume: 75
Issue: 1
Start Page: 149
End Page: 158
Publisher DOI: 10.1007/s13304-022-01402-6
Abstract: This study aimed to investigate the incidence and prognosis of postoperative complications after laparoscopic total gastrectomy (LTG) for gastric cancer (GC). We retrospectively enrolled 411 patients who underwent curative LTG for GC at seven institutions between January 2004 and December 2018. The patients were divided into two groups, complication group (CG) and non-complication group (non-CG), depending on the presence of serious postoperative complications (Clavien-Dindo grade III [>= CD IIIa] or higher complications). Short-term outcomes and prognoses were compared between two groups. Serious postoperative complications occurred in 65 (15.8%) patients. No significant difference was observed between the two groups in the median operative time, intraoperative blood loss, number of lymph nodes harvested, or pathological stage; however, the 5-year overall survival (OS; CG 66.4% vs. non-CG 76.8%; p = 0.001), disease-specific survival (DSS; CG 70.1% vs. non-CG 76.2%; p = 0.011), and disease-free survival (CG 70.9% vs. non-CG 80.9%; p = 0.001) were significantly different. The Cox multivariate analysis identified the serious postoperative complications as independent risk factors for 5-year OS (HR 2.143, 95% CI 1.165-3.944, p = 0.014) and DSS (HR 2.467, 95% CI 1.223-4.975, p = 0.011). A significant difference was detected in the median days until postoperative recurrence (CG 223 days vs. non-CG 469 days; p = 0.017) between the two groups. Serious postoperative complications after LTG negatively affected the GC prognosis. Efforts to decrease incidences of serious complications should be made that may help in better prognosis in patients with GC after LTG.
Rights: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 海老原 裕磨

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