The Effect of Postoperative Referred Pain in the Left Shoulder on Short-term Outcomes for Laparoscopic Gastrectomy
The Effect of Postoperative Referred Pain in the Left Shoulder on Short-term Outcomes for Laparoscopic Gastrectomy
The purpose of this study is to explore the effect of postoperative referred pain in the left
 shoulder on short-term outcomes for laparoscopic gastrectomy
A prospective cohort study will be performed to explore the effect of postoperative referred
 pain in the left shoulder on short-term outcomes for laparoscopic（including robot assisted
 laparoscopic surgery） gastrectomy .The evaluation parameters are overall postoperative
 morbidity rates,perioperative clinical efficacy and 3-year survival and recurrence rates.
Inclusion Criteria:

 -  Age from 18 to 75 years

 -  Primary gastric adenocarcinoma (papillary, tubular, mucinous, signet ring cell, or
 poorly differentiated) confirmed pathologically by endoscopic biopsy

 -  cT1-4a, N0-3, M0 at preoperative evaluation according to the American Joint Committee
 on Cancer (AJCC) Cancer Staging Manual Seventh Edition

 -  No distant metastasis is observed. And the spleen, pancreas or other adjacent organs
 are not involved by the tumor.

 -  Performance status of 0 or 1 on Eastern Cooperative Oncology Group scale (ECOG)

 -  American Society of Anesthesiology score (ASA) class I, II, or III

 -  Written informed consent

 Exclusion Criteria:

 -  patients whose previous history of chronic shoulder pain

 -  Women during pregnancy or breast-feeding

 -  Severe mental disorder

 -  History of previous upper abdominal surgery (except laparoscopic cholecystectomy)

 -  History of previous gastrectomy, endoscopic mucosal resection or endoscopic submucosal
 dissection

 -  Enlarged or bulky regional lymph node envelop important vessels

 -  History of other malignant disease within past five years

 -  History of previous neoadjuvant chemotherapy or radiotherapy

 -  History of unstable angina or myocardial infarction within past six months

 -  History of cerebrovascular accident within past six months

 -  History of continuous systematic administration of corticosteroids within one month

 -  Requirement of simultaneous surgery for other disease

 -  Emergency surgery due to complication (bleeding, obstruction or perforation) caused by
 gastric cancer

 -  FEV1<50% of predicted values

 -  Difficulty of understanding V A S(Visual Analogues Score).