Clinical Outcomes of Laparoscopy-assisted Gastrectomy for Patients With Heart Disease

Laparoscopy-assisted gastrectomy (LG) is an established treatment for early gastric cancer. However, CO2 pneumo- peritoneum during laparoscopic surgery can adversely affect car- diac function in the presence of heart disease (HD). We performed LG in 546 patients and conventional open gastrectomy (OG) in 448 patients. Patients with preoperatively diagnosed and treated HD were identified. The clinical outcomes of patients with HD who underwent LG (HD-LG) were compared with those of patients with HD who underwent OG (HD-OG), as well as those of patients with no operative risk who underwent LG (NR-LG). Variables of cardiac function were similar in the HD-LG and HD-OG groups. Postoperative cardiac complications did not differ between the groups (8.3% vs. 13.6%, P = 0.51). The HD-LG group had sig- nificantly more cardiac and abdominal complications than the NR-LG group (P = 0.0011 and 0.0070, respectively). LG was tol- erated in patients with gastric cancer and mild or moderate HD, similar to OG.