Comparison of complications between laparoscopic and open gastrectomies for early gastric cancer: a nationwide propensity score-matched cohort study

Abstract

Background The safety of laparoscopic gastrectomy compared with open surgery for the treatment of early gastric cancer (EGC) was not still identified on a national scale. This study aimed to compare the morbidity between laparoscopic and open gastrectomies for pathological T1 gastric cancer based on nationwide survey data. Methods Data from the Korean Gastric Cancer Association-led nationwide survey 2019 of 14,076 patients who underwent gastric cancer surgery were used. For patients with pathological T1 gastric cancer, the clinical characteristics were compared between the laparoscopic and open gastrectomy groups. Propensity score matching (PSM) was performed to match the baseline characteristics of two groups. Results Among the 7,765 patients with pathological T1 gastric cancer who underwent open or laparoscopic gastrectomy, 612 pairs were matched. After balancing the baseline characteristics, laparoscopic gastrectomy group had significantly longer operative time, less blood loss, greater number of harvested lymph nodes, shorter hospital stays, and comparable morbidity, compared with open gastrectomy group (P < 0.001, P < 0.001, P < 0.001, P = 0.001, and P = 0.709, respectively). The surgical approach was not a risk factor for postoperative complication in logistic regression analysis. Conclusions The PSM analysis with 2019 Korean nationwide survey data demonstrated that laparoscopic gastrectomy showed comparable morbidity with open gastrectomy for EGC.