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 4 Postoperative recovery and complications, 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
Time to first flatus	2.80 (2.60, 3.20)	3.35 (2.80, 3.60)	< 0.001^a	2.80 (2.60, 3.20)	3.30 (2.80, 3.50)	< 0.001^a	2.80 (2.60, 3.20)	3.39 (2.84, 3.60)	< 0.001^a
Time to first oral intake	2.80 (2.60, 3.30)	3.40 (2.88, 3.60)	< 0.001^a	2.80 (2.60, 3.30)	3.40 (2.80, 3.60)	0.001^a	2.80 (2.60, 3.30)	3.40 (2.90, 3.60)	< 0.001^a
Postoperative length of stay	9.00 (8.00, 10.0)	10.0 (9.00, 12.0)	< 0.001^a	9.00 (8.00, 10.0)	10.0 (9.00, 12.0)	< 0.001^a	9.00 (8.0, 10.0)	10.30 (9.0, 12.0)	< 0.001^a
Pain score on postoperative day 1	4.00 (4.00, 5.00)	5.00 (5.00, 6.00)	< 0.001^a	4.00 (4.00, 5.00)	6.00 (5.00, 6.00)	< 0.001^a	4.00 (4.00, 5.00)	5.26 (5.00, 6.00)	< 0.001^a
Pain score on postoperative day 2	2.00 (2.00, 3.00)	3.00 (2.00, 4.00)	0.002^a	2.00 (2.00, 3.00)	3.00 (2.00, 4.00)	0.003^a	2.00 (2.00, 3.00)	3.00 (2.00, 4.00)	0.007^a
Pain score on postoperative day 3	1.00 (0.00, 2.00)	1.00 (1.00, 2.00)	0.067	1.00 (0.00, 1.75)	1.00 (1.00, 2.00)	0.048^a	1.00 (0.00, 1.89)	1.00 (1.00, 2.00)	0.079
Complications¹			0.361	-		0.183	-		0.219
No	59 (71.1)	57 (59.4)	-	52 (70.3)	45 (60.8)	-	50.21 (71.4)	50.22 (58.2)	-
Anastomotic or duodenal stump leakage	3 (3.61)	3 (3.12)	-	3 (4.05)	1 (1.35)	-	2.47 (3.51)	2.05 (2.38)	-
Anastomotic bleeding	1 (1.20)	0 (0.00)	-	1 (1.35)	0 (0)	-	0.83 (1.18)	0.00 (0.00)	-
Intestinal obstruction	7 (8.43)	12 (12.5)	-	7 (9.46)	12 (16.2)	-	6.82 (9.70)	10.48 (12.6)	-
Lymphatic leakage	4 (4.82)	3 (3.12)	-	4 (5.41)	1 (1.35)	-	2.89 (4.11)	2.43 (2.81)	-
Gastrointestinal dysfunction	4 (4.82)	8 (8.33)	-	3 (4.05)	5 (6.76)	-	3.31 (4.70)	7.66 (8.88)	-
Incision infection	5 (6.02)	13 (13.5)	-	4 (5.41)	10 (13.5)	-	3.82 (5.42)	13.38 (15.5)	-
Re operation			1.000	-		1.000			0.740
No	79 (95.2)	91 (94.8)		70 (94.6)	71 (95.9)		65.90 (93.7)	81.84 (94.9)
Yes	4 (4.82)	5 (5.21)		4 (5.41)	3 (4.05)		4.45 (6.33)	4.38 (5.08)
Perioperative death			1.000	-		1.000	-		0.720
No	81 (97.6)	94 (97.9)		72 (97.3)	73 (98.6)		68.40 (97.2)	84.57 (98.1)
Yes	2 (2.41)	2 (2.08)		2 (2.70)	1 (1.35)		1.95 (2.77)	1.66 (1.92)
Textbook outcome	-		< 0.001^a	-		0.003^a	-		< 0.001^a
No	18 (21.7)	46 (47.9)		17 (23.0)	35 (47.3)		15.56 (22.1)	42.72 (49.6)
Yes	65 (78.3)	50 (52.1)		57 (77.0)	39 (52.7)		54.78 (77.9)	43.50 (50.5)

^aP < 0.05.

¹Postoperative complications mainly refer to surgery-related complications, including the seven conditions listed in the table. The diagnosis of all complications was based on one or more of the followings: The patient’s symptoms, physical examinations, laboratory tests (e.g., blood routine, drainage amylase and bilirubin tests, and bacterial culture and identification), upper gastrointestinal angiography, gastroscopy, and computed tomography examination.

PSM: Propensity score matching; IPTW: Inverse probability of treatment weighting.

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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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