Statistical Analysis
tumor, pneumonia, anastomotic leakage, Comorbidity
TUMOR, INTRAOPERATIVE COMPLICATIONS, PNEUMONIA, EVENT, PULMONARY COMPLICATIONS, CARDIAC COMPLICATIONS, REGRESSION, COMPLICATIONS
Patient, tumor, and treatment characteristics of patients who underwent laparoscopic versus open gastrectomy were compared within the LOGICA and DUCA data sets using univariate analyses. These characteristics included sex, age, body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index, tumor location, cT, cN, cM, neoadjuvant treatment, surgical procedure, and year of surgery. Mann-Whitney Multilevel multivariable logistic regression analyses were performed to assess the effect of laparoscopic versus open gastrectomy upon clinical outcomes, including length of hospital stay, readmission, reoperation and endoscopic/radiologic reintervention, oncological outcomes, including resection radicality (R0) and number of resected lymph nodes; and complications including; intraoperative complications, overall complications, severe complications ≥Clavien-Dindo grade IIIa), anastomotic leakage, cardiac complications, pulmonary complications, pneumonia, and 30-day/in-hospital mortality), while adjusting for patient, tumor and treatment variables, as described above. To adjust for potential changes over time, year of surgery was added as a random effect factor within the multivariate model in the event the log-likelihood ratio test showed a better fit compared with the original model. In case of insufficient degrees of freedom to correct for the entire correction model, only confounders leading to a >10% change in odds ratio of the outcome were included in the multivariate model. These analyses were repeated to assess the effect of laparoscopic gastrectomy upon outcomes before (January 2012 to January 2015), during (February 2015 to August 2018), and after (September 2018 to December 2021) the LOGICA trial in the DUCA data set. Subgroup analyses were performed to match the DUCA data set to the inclusion and exclusion criteria of the LOGICA trial (curative resection, D2-lymphadenectomy, and M0), to classify conversions in the open cohort (per-protocol), and by excluding the first 20 laparoscopic gastrectomy cases of each center in the DUCA data set. Overall, 