Laparoscopic versus open gastrectomy for gastric cancer patients with COPD

Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of developing postoperative pulmonary complications. Laparoscopic gastrectomy (LG) is accepted as a standard treatment for early gastric cancer. We sought to compare the clinical presentation and complications associated with LG and open gastrectomy (OG) to define the role of LG in the treatment of patients with gastric cancer and COPD.

This was a retrospective cohort study of patients with gastric cancer and COPD who underwent gastrectomy from January 2005 to December 2007. Patients were divided into LG group and OG group according to the treatment guidelines. The stage of COPD was determined by the FEV1 ratio.

There were 104 patients enrolled in this study. No significant differences were observed in preoperative pulmonary function between the two groups, and most patients (99/104, 95%) were in COPD stages I and II. The changes in end-tidal CO(2) (P = 0.012) and PaCO(2) (P < 0.001) during surgery were statistically significant in the LG group. There were no significant differences in incidence of postoperative pulmonary complications between the LG (5/61, 8%) and OG (4/43, 9%) groups.

LG can be performed safely for patients with gastric cancer and COPD in stage I and II.