Clinical Research Of Postoperative Complications Of Laparoscopic Versus Open Gastrectomy In Gastric Cancer Patients With Neoadjuvant Treatment

Objective To compare the clinical characteristics of laparoscopic and open gastrectomy after neoadjuvant treatment,and to analyze the risk factors of postoperative complications.Methods We retrospectively reviewed 490 patients who received neoadjuvant treatment and radical gastrectomy at Cancer Hospital of Chinese Academy of Medical Sciences from January 2008 to December 2018,including laparoscopic(n=347)or traditional open surgery(n=143).We compared the incidence and characteristics of complications,conducted univariate and multivariate analysis of complications.Results The incidence of complications was 17.8%(87/490).The main complications included postoperative bleeding,anastomotic leakage,postoperative obstruction,postoperative stenosis,lung infection,and abdominal infection.Clavien-Dindo classification:14 cases in grade Ⅰ,49 cases in grade Ⅱ,14 cases in grade Ⅲa,3 cases in grade Ⅲb,13 cases in grade Ⅳ and 8 cases in grade Ⅴ.The incidence of complications in the open surgery group were 15.3%(19/143),and in the laparoscopic surgery group was 19.6%(68/347),but there was no statistical difference between the two groups on the incidence of complications(P>0.05).Multivariate analysis showed that age and surgical approach were independent risk factors that affecting the incidence of complications.Conclusion Compared with open surgery,laparoscopic gastrectomy does not increase the incidence of surgical complication.Clavien-Dindo classification method is valuable for clinical application to analyze the surgical complications of neoadjuvant gastric cancer patients.