Laparoscopic compared to open approach for distal gastrectomy may reduce pneumonia risk for patients with gastric cancer

Kyle D. Klingbeil, MD MS; Michael Mederos, MD; Joon Y. Park, MD; Young-Ji Seo, MD; Daniela Markovic, MS; Victor Chui, MD; Mark Girgis, MD; Brian E. Kadera, MD

Surgery Open Science (Aug 2023)

Laparoscopic compared to open approach for distal gastrectomy may reduce pneumonia risk for patients with gastric cancer

Kyle D. Klingbeil, MD MS,
Michael Mederos, MD,
Joon Y. Park, MD,
Young-Ji Seo, MD,
Daniela Markovic, MS,
Victor Chui, MD,
Mark Girgis, MD,
Brian E. Kadera, MD

Affiliations

Kyle D. Klingbeil, MD MS: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Corresponding author at: Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, 54-117, Los Angeles, CA 90095, USA.
Michael Mederos, MD: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Joon Y. Park, MD: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Young-Ji Seo, MD: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Daniela Markovic, MS: Department of Medicine, Statistics Core, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Victor Chui, MD: Department of Medicine, Division of Hematology and Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Mark Girgis, MD: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
Brian E. Kadera, MD: Department of Surgery, Division of Surgical Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

Journal volume & issue: Vol. 14
pp. 68 – 74

Abstract

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Background: Whether laparoscopic approach to gastrectomy for gastric cancer (GC) reduces the risk of pneumonia remains unknown. In this study, we compared pneumonia outcomes for patients with GC who underwent either laparoscopic gastrectomy (LG) or open gastrectomy (OG). Methods: The ACS NSQIP database was queried to identify patients with GC who underwent LG or OG between Jan 2012 - Dec 2018. Outcomes were compared using regression models. A post-hoc analysis was performed for elderly patients. Results: The study cohort included 2661 patients, 23.4 % undergoing LG. Laparoscopic approach lowered pneumonia risk (OR 0.47, p = .028) and reduced hospital length of stay, (5.3 vs 7.1 days, p < .001). Elderly patients undergoing LG demonstrated similar benefits. Risk factors for pneumonia included advanced age, dyspnea and weight-loss, whereas laparoscopic approach reduced this risk. Conclusions: LG in patients with GC has both statistically and clinically significant advantages over OG with respect to pneumonia. Further studies are needed to validate the relationship between postoperative pneumonia and surgical approach for gastrectomy.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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