Journal of Gastric Cancer
- 제8권2호
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- Pages.85-90
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- 2008
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- 2093-582X(pISSN)
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- 2093-5641(eISSN)
평균 수명 이상의 고령 위암 환자에서의 D2 림프절 절제술의 안정성
Evaluation of the Safety and Feasibility of D2 Lymphadenectomy in Elderly Patients with Gastric Cancer
- 강우성 (화순전남대학교병원 외과) ;
- 정오 (화순전남대학교병원 외과) ;
- 정미란 (화순전남대학교병원 외과) ;
- 김호군 (화순전남대학교병원 외과) ;
- 류성엽 (화순전남대학교병원 외과) ;
- 박영규 (화순전남대학교병원 외과) ;
- 김동의 (화순전남대학교병원 외과) ;
- 김영진 (화순전남대학교병원 외과)
- Kang, Woo Sung (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Cheong, Oh (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Jeong, Mi Ran (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Kim, Ho Goon (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Ryu, Sung Yeop (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Park, Yeong Kyu (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Kim, Dong Yi (Department of Surgery, Chonnam National University Hwasun Hospital) ;
- Kim, Young Jin (Department of Surgery, Chonnam National University Hwasun Hospital)
- 투고 : 2008.04.25
- 심사 : 2008.06.07
- 발행 : 2008.06.30
초록
목적: 고령 위암환자의 근치적 절제 후 생존율은 약년층에 비해 낮지 않다고 보고되고 있으나 고령 환자에 대한 적절한 수술 범위에 대해서는 저자들마다 이견이 많다. 본 연구에서는 D2 림프절 절제술이 시행된 고령 위암환자들의 수술 후 경과 및 합병증에 관하여 분석하여 고령 환자에서 D2 림프절 절제술의 안정성을 평가하고자 하였다. 대상 및 방법: 2004년 5월부터 2007년 5월까지 위암으로 근치적 위절제를 시행 받은 1,251명 중 D2 림프절 절제술을 시행 받았던 946명을 대상으로 국내 평균수명인 남자 73세, 여자 80세 이상을 고령환자로 구분 하여 비 고령 환자와 비교하였다. 결과: 전체 고령 환자 120명 가운데 86명(72.2%)에게 D2 이상의 림프절 절제술이 시행되었다. 고령 D2 림프절제술 환자의 남녀비는 11.3:1이었고, 평균 연령은
Purpose: The aim of this study was to evaluate the safety and feasibility of D2 lymphadenectomy in elderly patients with gastric cancerby comparing the surgical outcomes and postoperative courses between an elderly group and a control group undergoing the same procedure. Materials and Methods: Clinical information was reviewed for 1251 patients with gastric cancer who underwent gastrectomy between May 2004 and May 2007. Patients were classified into the following two groups: an elderly group (older than the average life span in Korea) and a control group (younger than the elderly group). Clinicopathologic features and postoperative courses after D2 lymphadenectomy were reviewed and compared between the two groups. Results: There were a total of 120 (9%) elderly group patients among all those reviewed, and 86 (72.2%) of them underwent D2 lymphadenectomy. There was 27.5% postoperative morbidity in the elderly group, which was significantly different from thecontrol group (12.8%, p=0.003). However, on multivariate analysis, ASA score and combined resection were independent predictive factors of postoperative complications, while age was not predictive. Conclusion: Older age is not a predictive factor of postoperative complications in itself, and D2 lymphadenectomy can be safely performed in elderly patients with gastric cancer, provided they have good ASA scores and do not undergo accompanying combined resection.