Open AccessSurgical outcomes of laparoscopic distal gastrectomy compared to open distal gastrectomy: A retrospective cohort study based on a nationwide registry database in Japan
Author(s) -
Yoshida Kazuhiro,
Honda Michitaka,
Kumamaru Hiraku,
Kodera Yasuhiro,
Kakeji Yoshihiro,
Hiki Naoki,
Etoh Tsuyoshi,
Miyata Hiroaki,
Yamashita Yuichi,
Seto Yasuyuki,
Kitano Seigo,
Konno Hiroyuki
Publication year - 2018
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12054
Subject(s) - medicine , retrospective cohort study , propensity score matching , cohort , gastrectomy , stage (stratigraphy) , cancer , surgery , database , paleontology , biology , computer science
To clarify the safety profile of laparoscopic distal gastrectomy ( LDG ) for gastric cancer patients, the short‐term outcome of LDG was compared to that of open distal gastrectomy ( ODG ) by propensity score matching using data from the Japanese National Clinical Database ( NCD ). We conducted a retrospective cohort study of patients undergoing distal gastrectomy between January 2012 and December 2013. Using the data for 70 346 patients registered in the NCD , incidences of mortality and morbidities were compared between LDG patients and ODG patients in the propensity score matched stage I patients ( ODG : n = 14 386, LDG : n = 14 386) and stage II ‐ IV patients ( ODG : n = 3738, LDG : n = 3738), respectively. There was no significant difference in mortality rates between LDG and ODG at all stages. Operating time was significantly longer in LDG compared to ODG , whereas blood loss and incidences of superficial surgical site infection ( SSI ), deep SSI , and wound dehiscence were significantly higher in ODG at all stages. Interestingly, pancreatic fistula was found significantly more often in LDG (1%) compared to ODG (0.8%) ( P = .01) in stage I patients; however, it was not different in stage II ‐ IV patients. The length of postoperative stay was significantly longer in patients undergoing ODG compared to LDG at all stages. LDG in general practice might be a feasible therapeutic option in patients with both advanced gastric cancer and those with early gastric cancer in Japan.