Analysis of predictive risk factors for postoperative complications of laparoscopy-assisted distal gastrectomy.

Kim, Hee Sung; Kim, Min Gyu; Kim, Beom Su; Lee, In Seob; Lee, Sol; Yook, Jeoung Hwan; Kim, Byung Sik

BACKGROUND Despite the popularity of laparoscopic-assisted distal gastrectomy (LADG), studies have reported a high incidence of postoperative complications in patients who have had LADG. The present study explores the preoperative risk factors for complications from LADG. PATIENTS AND METHODS This study involves 1257 patients who underwent standardized LADG in a single institution between January 2006 and June 2011. The risk factors for postoperative complications of LADG were evaluated by univariate and multivariate analyses. RESULTS In univariate analysis of overall postoperative complications, there were significant effects of age (above 65 years), obesity (a body mass index above 25 kg/m(2)), comorbidity, cerebrovascular disease, heart disease, hypertension, diabetes mellitus, and combined comorbidities (three or more). Multivariate analysis of these risk factors showed that old age (P=.006), obesity (P<.001), and heart disease (P=.014) were independent risk factors for postoperative complications. Univariate analysis showed that obesity also had a significant effect on severe postoperative complications. CONCLUSIONS Older age, obesity, and heart disease are risk factors for postoperative complications after LADG. Greater caution or more limited surgery is required to reduce the high rate of complications in patients with these risk factors.