Laparoscopy-assisted gastrectomy remains safe and feasible for gastric cancer patients with a history of upper abdominal surgery

doi:10.3748/wjg.v32.i23.118489

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jun 21, 2026; 32(23): 118489
Published online Jun 21, 2026. doi: 10.3748/wjg.v32.i23.118489

Table 3 Surgical and pathological outcomes, n (%)

Characteristics	Overall cohort (unadjust)			PSM cohort			IPTW cohort
Characteristics	Laparoscopic (n = 83)	Open (n = 96)	P value	Laparoscopic (n = 74)	Open (n = 74)	P value	Laparoscopic (n = 70.35)	Open (n = 86.23)	P value
Surgical outcome
Surgical procedure	-		0.951	-		0.815	-		0.976
Proximal gastrectomy	19 (22.9)	22 (22.9)		12 (16.2)	15 (20.3)		14.69 (20.9)	18.41 (21.4)
Distal gastrectomy	44 (53.0)	49 (51.0)		43 (58.1)	41 (55.4)		37.78 (53.7)	44.87 (52.0)
Total gastrectomy	20 (24.1)	25 (26.0)		19 (25.7)	18 (24.3)		17.87 (25.4)	22.95 (26.6)
Operation time	229 (20.4)	214 (20.1)	< 0.001^a	229 (20.7)	212 (20.7)	< 0.001^a	230.00 (220, 240)	210.00 (200, 225)	< 0.001^a
Estimated blood loss	160 (140, 200)	180 (150, 200)	0.366	165 (150, 200)	180 (150, 200)	0.730	155.25 (140, 200)	180.00 (150, 200)	0.281
Conversion to open surgery¹			0.002^a	-		0.006^a	-		0.001^a
No	75 (90.4)	96 (100)		66 (89.2)	74 (100)		62.49 (88.8)	86.23 (100)
Yes	8 (9.64)	0 (0.00)		8 (10.8)	0 (0.00)		7.86 (11.2)	0.00 (0.00)
Iatrogenic injury²			0.803	-		0.743	-		0.502
No	77 (92.8)	91 (94.8)		68 (91.9)	70 (94.6)		64.90 (92.3)	81.76 (94.8)
Yes	6 (7.23)	5 (5.21)		6 (8.11)	4 (5.41)		5.45 (7.75)	4.47 (5.18)
Pathological outcome
R0 resection achieved	83 (100)	96 (100)	1.000	74 (100)	74 (100)	1.000	70.35 (100)	86.23 (100)	1.000
Total lymph node number	35.0 (27.0, 42.5)	35.0 (25.0, 38.5)	0.510	37.0 (28.0, 45.8)	34.5 (25.0, 37.8)	0.186	34.91 (26.69, 40.00)	35.00 (25.00, 38.10)	0.591
pTNM			0.668	-		0.762	-		0.708
I	31 (37.3)	33 (34.4)		27 (36.5)	26 (35.1)		25.39 (36.1)	28.04 (32.5)
II	25 (30.1)	35 (36.5)		22 (29.7)	26 (35.1)		21.88 (31.1)	32.14 (37.3)
III	27 (32.5)	28 (29.2)		25 (33.8)	22 (29.7)		23.09 (32.8)	26.05 (30.2)

^aP < 0.05.

¹Reasons for conversion to open surgery only included failure to place trocars and unseparated severe adhesion.

²Iatrogenic injury mainly included bowel injury, portal vein injury, and splenic bleeding.

PSM: Propensity score matching; IPTW: Inverse probability of treatment weighting; pTNM: Pathological tumor-node-metastasis.

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Citation: Wang P, Song YJ, Liu X, Jiang YJ, He Y, Song YB. Laparoscopy-assisted gastrectomy remains safe and feasible for gastric cancer patients with a history of upper abdominal surgery. World J Gastroenterol 2026; 32(23): 118489
URL: https://www.wjgnet.com/1007-9327/full/v32/i23/118489.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i23.118489

Wang P, Song YJ, Liu X, Jiang YJ, He Y, Song YB. Laparoscopy-assisted gastrectomy remains safe and feasible for gastric cancer patients with a history of upper abdominal surgery. World J Gastroenterol 2026; 32(23): 118489 [DOI: 10.3748/wjg.v32.i23.118489]

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