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

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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 5 Subgroup analysis of perioperative and pathological outcomes between laparoscopic and open surgery stratified by risk status

Characteristics	High risk group			Low risk group
Characteristics	Laparoscopic (n = 36)	Open (n = 38)	P value	Laparoscopic (n = 47)	Open (n = 58)	P value
Surgical procedure			0.972	-		0.818
Proximal gastrectomy	9 (25.0)	9 (23.7)		10 (21.3)	13 (22.4)
Distal gastrectomy	17 (47.2)	19 (50.0)		27 (57.4)	30 (51.7)
Total gastrectomy	10 (27.8)	10 (26.3)		10 (21.3)	15 (25.9)
Operation time	229 (18.7)	212 (18.9)	< 0.001^a	230 (21.8)	216 (20.9)	0.001^a
Estimated blood loss	180 (150, 200)	170 (150, 198)	0.127	150 (125, 200)	200 (150, 200)	0.037^a
Iatrogenic injury			0.610	-		1.000
No	34 (94.4)	37 (97.4)		43 (91.5)	54 (93.1)
Yes	2 (5.56)	1 (2.63)		4 (8.51)	4 (6.90)
Time to first flatus	2.80 (2.60, 3.20)	3.30 (2.82, 3.50)	0.008^a	2.80 (2.60, 3.20)	3.40 (2.82, 3.60)	< 0.001^a
Time to first oral intake	2.80 (2.60, 3.23)	3.30 (2.82, 3.58)	0.014^a	2.80 (2.60, 3.40)	3.50 (2.90, 3.70)	0.004^a
Postoperative length of stay	9.00 (8.00, 10.0)	10.0 (9.00, 11.8)	0.102	9.00 (8.00, 10.0)	11.0 (9.00, 13.0)	< 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
Pain score on postoperative day 2	2.00 (2.00, 3.00)	2.50 (2.00, 3.75)	0.062	2.00 (2.00, 3.00)	3.00 (2.00, 4.00)	0.016^a
Pain score on postoperative day 3	1.00 (0.00, 1.00)	1.00 (1.00, 2.00)	0.065	1.00 (0.00, 2.00)	1.00 (1.00, 2.00)	0.419
Complications			0.527	-		0.614
No	24 (66.7)	20 (52.6)	-	35 (74.5)	37 (63.8)	-
Anastomotic or duodenal stump leakage	1 (2.78)	2 (5.26)	-	2 (4.26)	1 (1.72)	-
Anastomotic bleeding	1 (2.78)	0 (0.00)	-	0 (0.00)	0 (0.00)	-
Intestinal obstruction	4 (11.1)	4 (10.5)	-	3 (6.38)	8 (13.8)	-
Gastrointestinal dysfunction	1 (2.78)	4 (10.5)	-	3 (6.38)	4 (6.90)	-
Lymphatic leakage	2 (5.56)	1 (2.63)	-	2 (4.26)	2 (3.45)	-
Incision infection	3 (8.33)	7 (18.4)	-	2 (4.26)	6 (10.3)	-
Re operation			0.351	-		0.377
No	33 (91.7)	37 (97.4)		46 (97.9)	54 (93.1)
Yes	3 (8.33)	1 (2.63)		1 (2.13)	4 (6.90)
Perioperative death			1.000	-		0.586
No	36 (100)	37 (97.4)		45 (95.7)	57 (98.3)
Yes	0 (0.00)	1 (2.63)		2 (4.26)	1 (1.72)
R0 resection achieved	36 (100)	38 (100)		47 (100)	58 (100)
Total lymph node number	34.5 (19.5, 40.0)	34.0 (25.0, 38.0)	0.965	35.0 (28.0, 45.5)	35.0 (25.0, 40.0)	0.324
pTNM			0.609	-		0.804
I	12 (33.3)	13 (34.2)		19 (40.4)	20 (34.5)
II	11 (30.6)	15 (39.5)		14 (29.8)	20 (34.5)
III	13 (36.1)	10 (26.3)		14 (29.8)	18 (31.0)

^aP < 0.05.

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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