Comparative Analysis of Clavien–Dindo Grade and Risk Factors of Complications after Dual-Port Laparoscopic Distal Gastrectomy and Hand-Assisted Laparoscopic Gastrectomy

Abstract

Objective. To compare the Clavien–Dindo grade and risk factors of complications after dual-port laparoscopic distal gastrectomy (DPLDG) and hand-assisted laparoscopic gastrectomy (HALG). Methods. The clinical data of 775 patients who underwent DPLDG or HALG in our hospital from May 2016 to May 2019 were retrospectively reviewed, and the patients were divided into the DPLDG group (n = 386) and HALG group (n = 389) according to the surgical method to explore the risk factors of postoperative complications by grading their postoperative complications according to the Clavien–Dindo classification system and single-factor and multivariate analysis of the association between variables in clinical data and complications. Results. Compared with the HALG group, the DPLDG group had significantly shorter surgical time, less intraoperative blood loss, and better postoperative exhaust time $\left(p<0.05\right)$ , with no significant difference in other clinical indicators between the two groups $\left(p>0.05\right)$ ; the postoperative complication incidence rate of DPLDG group was significantly lower than that of the HALG group; it was shown in the single-factor analysis that the age, tumor length, intraoperative blood loss, pathological stages, and surgical method were related to the postoperative complications, and the results of multivariate analysis indicated that DPLDG was the protective factor for reducing postoperative complications, while age no less than 60 years old and intraoperative blood loss no less than 180 ml were the independent risk factors leading to complications; after surgery, the PNI level values at T1, T2, and T3 of DPLDG group were significantly higher than those of the HALG group $\left(p<0.05\right)$ ; and at 1 month after surgery, both groups obtained significantly higher GLQI scores than before, and the GLQI score of the DPLDG group was significantly higher in the between-group comparison $\left(p<0.05\right)$ . Conclusion. The DPLDG has lower postoperative complication incidence rate than the HALG, but age no less than 60 years old and intraoperative blood loss not less than 180 ml are the independent risk factors for postoperative complications, so advanced prevention measures shall be taken to lower the incidence of complications.