To investigate the incidence and prognosis of intra-abdominal infectious complications (IaIC) after laparoscopic and open radical gastrectomy for gastric cancer.
The data of patients who underwent radical gastrectomy for gastric cancer at the Fujian Medical University Union Hospital from January 2000 to December 2014, retrospectively LAG and OG were used. 1:1 propensity score matching (PSM) was used to reduce biases. The incidence and prognosis of postoperative IaIC in the two groups were analyzed.
The incidence of IaIC after OG and LAG was 4.1% and 5.1%, respectively(p=0.264). Cox multivariate analysis showed that IaIC was an independent risk factor for overall survival (OS) of patients undergoing gastrectomy (HR: 1.65, 95%CI: 1.23-2.20, p<0.001). Analysis also showed that LAG was an independent protective factor for OS with IaIC (HR 0.54, 95%CI: 0.31-0.96, p=0.036), and tumor diameter ≥ 50 mm (p=0.01) and pTNM III stage (p<0.001) were independent risk factors. After PSM, the five-year OS rate of patients with IaIC in the LAG was higher than that in the OG (51.1% vs. 32.4%, p=0.042). The independent preoperative risk factors for IaIC include male (OR 1.82, p=0.046) and BMI ≥ 25 (OR 1.88, p=0.021). Among patients with IaIC, the prognostic nutritional index (PNI) in OG group was similar to that in LAG group before operation (p=0.220), but lower than that in LAG group on the 1st, 3rd, and 5th day after surgery (p<0.05).
Compared to OG, LAG can improve the prognosis of patients with postoperative IaIC. For high-risk patients with IaIC, LAG is recommended.
The authors.
Scientific and Technological Innovation Joint Capital Projects of Fujian Province.
All authors have declared no conflicts of interest.