Analysis of Adverse Events and Related Factors in Laparoscopic Gastric Cancer Surgery

Wu Zuyin; Kou Mingwen; Zhang Jixin

doi:10.3969/j.issn.1004-5775.2025.23.007

Abstract：Objective:To summarize the incidence of adverse events during laparoscopic gastric cancer surgery and analyze the factors associated with the occurrence of adverse events during laparoscopic gastric cancer surgery.Methods:A retrospective analysis was conducted on the clinical data of 433 patients who underwent laparoscopic gastric cancer surgery at the 988th Hospital of the Logistics Support Force of the Chinese People's Liberation Army from April 2020 to April 2023.The incidence of intraoperative adverse events was statistically analyzed,and patients were divided into two groups based on the occurrence of intraoperative adverse events:the intraoperative adverse event group(n=32)and the non-intraoperative adverse event group(n=401).Factors such as gender,age,underlying diseases,body mass index(BMI),tumor characteristics(tumor size,location,stage,pathological differentiation,metastasis,etc.),and perioperative indicators(surgery duration,intraoperative blood loss)were analyzed for the two groups of patients.Logistic regression analysis was used to analyze the factors associated with the occurrence of intraoperative adverse events.Results:Among the 433 patients who underwent laparoscopic gastric cancer surgery,32 patients experienced adverse events during surgery,with an incidence rate of 7.39％.According to China's medical quality and safety adverse event grading and classification standards,the 32 patients who experienced adverse events during laparoscopic gastric cancer surgery were graded as follows:7 cases were grade Ⅳ,19 cases were grade Ⅲ,4 cases were grade Ⅱ,and 2 cases were grade I.Among these cases,there were 16 instances of intraoperative bleeding,6 cases of visceral injury,2 cases of bile duct injury,2 cases of vagus nerve injury,2 cases of anastomotic leakage,1 case of gas embolism,and 3 cases requiring conversion to open surgery.Univariate analysis revealed that age,tumor size,T stage,N stage,distant metastasis,surgical duration,and intraoperative blood loss were associated with the occurrence of intraoperative adverse events(P<0.05).Logistic regression analysis showed that distant metastasis,tumor size,surgical duration,and intraoperative blood loss were risk factors for the occurrence of intraoperative adverse events(P<0.05).Conclusion:In clinical treatment,adverse events during laparoscopic gastric cancer surgery are mainly grade Ⅲ,with intraoperative bleeding being the primary adverse event.Age,tumor size,T stage,N stage,distant metastasis,duration of surgery,and intraoperative blood loss are factors associated with the occurrence of adverse events during surgery.Distant metastasis,tumor size,duration of surgery,and intraoperative blood loss are risk factors for the occurrence of adverse events during surgery.