Abstract:
Objective To analyze perioperative complications of patients with early gastric cancer received additional laparoscopic gastrectomy after endoscopic submucosal dissection (ESD).
Methods A total of 756 patients received laparoscopic radical gastrectomy in the gastric cancer professional group of general surgery of Zhongshan Hospital, Fudan University from January 2009 to August 2019, among whom, 46 patients received ESD treatment before the operation (ESD group). And the data of 269 patients were included after 1:5 matching through propensity score matching (PSM), with 223 patients in the non-ESD group. Clinicopathologic factors and short-term surgical outcomes were retrospectively analyzed to evaluate the safety of laparoscopic gastrectomy following non-curative ESD. And the time interval between two operations was analyzed.
Results The incidence of grade Ⅱ-Ⅲ complications (21.74% vs 4.04%, P < 0.01), especially pancreatic leakage and peritoneal effusion combined with infection (P < 0.01). Compared to the other weeks, the risk of postoperative complications was higher in patients received laparoscopic surgery 3 weeks after ESD (75.00% vs 41.18%, P=0.044), and the risk of complications of laparoscopic surgery near 2 weeks after ESD may be low (16.67% vs 55%, P=0.093). There was no significantly statistical difference in the average length of hospital stay between patients received additional laparoscopic surgery after ESD and patients received conventional laparoscopic surgery.
Conclusions ESD may increase the risk of postoperative complications of patients received additional laparoscopic surgery, and the time interval between two operations should be selected cautiously.
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