30. Impact of previous abdominal operations on the outcome of laparoscopy-assisted radical total gastrectomy

Objective: To explore the impact of previous abdominal operations on the outcome of laparoscopy-assisted radical total gastrectomy (LATG).
Methods: The clinical data of 266 patients with gastric cancer underwent LATG from January 2008 to June 2010 were analyzed. Among the patients, 46 cases with previous abdominal surgeries (PAS group, 12 cases with previous gastrectomy, 34 cases with previous abdominal surgeries except for previous gastrectomy); 220 cases without previous abdominal surgeries (NPAS group).The recovery and complications were analyzed between two groups.87 The risk factors that determined postoperative complications were investigated by univariate and multivariate analysis.
Results: There were no significant differences between the two groups in the mean number of removal lymph nodes (LNs) (28.2±12.0 vs. 31.1±9.6). However, the mean number of removal LNs in the patients with previous gastrectomy was significantly less than with previous abdominal surgeries except for previous gastrectomy. There were no significant differences in each station except for stations No.5 and 6. The operation time and the postoperative morbidity were significantly between two groups, the other aspects of patints’ recovery were no significant differences. By logistic regression analysis, it was revealed that there were three significant factors for postoperative complications such as preoperative comorbidity, LN metastasis and the operation time. While previous abdominal surgeries wasn’t independent risk factor affecting the postoperative morbidity.
Conclusions: LATG is feasible for gastric cancer who has previous abdominal surgeries; previous abdominal surgeries don’t really increase the complication morbidity.