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Published in:

01-04-2016

Laparoscopic gastrectomy for gastric cancer in the elderly patients

Authors: Muneharu Fujisaki, Toshihiko Shinohara, Nobuyoshi Hanyu, Susumu Kawano, Yujiro Tanaka, Atsushi Watanabe, Katsuhiko Yanaga

Published in: Surgical Endoscopy | Issue 4/2016

Abstract

Background

This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure.

Methods

We retrospectively investigated 208 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and September 2014. After excluding 15 patients with unusual medical histories or surgical treatments, 193 were selected for this cohort study. We divided the patients into two cohorts: elderly patients (≥75 years old) and non-elderly patients (<74 years old). We compared these cohorts with respect to clinicopathological characteristics and intraoperative and postoperative parameters.

Results

The overall complication rates were 11.4 % (8 of 70 patients) in the elderly cohort and 8.1 % (10 of 123 patients) in the non-elderly cohort (P = 0.449). In a univariate analysis, Charlson comorbidity index (CCI) of ≥3, American Society of Anesthesiologists (ASA) score of 3, operative time of ≥330 min, and intraoperative blood loss of ≥50 ml were found to correlate significantly with postoperative complications. In a multivariate analysis, CCI of ≥3 (P = 0.034), ASA score of 3 (P = 0.019), and intraoperative blood loss of ≥50 ml (P = 0.016) were found to be independent risk factors of postoperative complications. In contrast, age was not found to significantly affect the risk of postoperative complications.

Conclusions

Laparoscopic gastrectomy for gastric cancer can be successfully performed in elderly patients with an acceptable complication rate. This study suggested that high CCI, ASA score, and intraoperative blood loss volume were identified as independent predictors of postoperative complications after laparoscopic gastrectomy for gastric cancer.

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Title: Laparoscopic gastrectomy for gastric cancer in the elderly patients
Authors: Muneharu Fujisaki
Toshihiko Shinohara
Nobuyoshi Hanyu
Susumu Kawano
Yujiro Tanaka
Atsushi Watanabe
Katsuhiko Yanaga
Publication date: 01-04-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 4/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4340-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic gastrectomy for gastric cancer in the elderly patients

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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