• Masanori Tokunaga, Junya Kondo, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, and Masanori Terashima.
• Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. m.tokunaga@scchr.jp
• J. Gastrointest. Surg. 2012 Oct 1;16(10):1854-9.

BackgroundLaparoscopy-assisted gastrectomy (LAG) has been increasingly used for the treatment of early gastric cancer, and many advantages over open gastrectomy (OG) have been reported. However, only a few reports have assessed postoperative complications following LAG using the Clavien-Dindo classification.MethodsA total of 265 patients who underwent distal gastrectomy or pylorus-preserving gastrectomy with D1+ lymph node dissection for clinical stage IA early gastric cancer at the Shizuoka Cancer Center between June 2009 and December 2011 were included in this study. Clinicopathological characteristics and early surgical outcomes were compared between patients who underwent LAG (LAG group, n = 129) and those who underwent OG (OG group, n = 136). The severity of postoperative morbidities was assessed according to the Clavien-Dindo classification.ResultsThere were no differences in sex or age between the two groups. Body mass index (21.97 vs. 23.19, P < 0.001) was lower in the LAG group than the OG group. The duration of the postoperative hospital stay was similar between the two groups (9 days each, P = 0.511). There was no difference in the overall morbidity rate (grade II or higher) between the two groups (LAG group, 7.0%; OG group, 8.1%; P = 0.818). The incidence of grade IIIa or more severe morbidities was also not significantly different between the LAG group (4.7%) and OG group (2.9%, P = 0.532).ConclusionsThere was no significant difference in postoperative complication rates between the LAG and the OG groups. The more severe Clavien-Dindo grade III complications, which required surgical interventions, were observed at similar rates between the two groups. Laparoscopic gastrectomy for early gastric cancer is therefore feasible in terms of the incidence and severity of intra-abdominal complications.

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