Surgery · Oncology · 3 h ago
Dissection time linked to complications after laparoscopic distal gastrectomy
A retrospective multicenter study of 849 patients with distal gastric cancer identified 133 minutes as the cutoff for prolonged intraoperative dissection. Longer dissection time was associated with more postoperative complications, but was not independently associated with survival after adjustment.
- 133 minutes was the identified dissection-time cutoff.
- Longer times were associated with more postoperative complications.
- Dissection time was not independently associated with survival.
- Prediction models showed moderate discrimination in validation.
Researchers retrospectively studied 849 patients who underwent laparoscopic distal gastrectomy for distal gastric cancer at three tertiary centers between November 2020 and May 2025. They used postoperative complications to identify a cutoff for intraoperative dissection time, then compared outcomes between patients above and below that threshold. Six machine-learning models were developed and validated to predict prolonged dissection time.
The identified cutoff was 133 minutes. Patients with longer dissection times had more postoperative complications and worse overall and recurrence-free survival in unadjusted analyses. However, dissection time was not independently associated with prognosis in multivariable analysis. The longer-time group also had higher body mass index, larger tumors, more advanced clinical stage, and more frequent neoadjuvant chemotherapy. Logistic regression had the highest test-cohort area under the curve (0.770); random forest performed best in the validation cohort (0.759).
The findings identify a possible risk marker, not evidence that reducing dissection time improves outcomes. The retrospective design and differences in patient and tumor characteristics limit causal interpretation; the prediction models require further evaluation before their clinical utility is established.
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Surgical Endoscopy: Clinical significance of intraoperative dissection time and machine learning-based prediction in laparoscopic distal gastrectomy for gastric cancer ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.