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Laparoscopy-Assisted Distal Gastrectomy for Early Gastric Cancer in the Elderly

  • Kim, Eun Ji (Department of Surgery, Kosin University College of Medicine) ;
  • Seo, Kyung Won (Department of Surgery, Kosin University College of Medicine) ;
  • Yoon, Ki Young (Department of Surgery, Kosin University College of Medicine)
  • Received : 2012.07.05
  • Accepted : 2012.10.20
  • Published : 2012.12.31

Abstract

Purpose: With an increase in life expectancy, more elderly patients are presenting with gastric cancer. As a result it is yet be resolved whether laparoscopy assisted distal gastrectomy is a suitable treatment for elderly patients with early gastric cancer. This study retrospectively compared surgical outcomes of laparoscopy assisted distal gastrectomy between elderly and nonelderly patients with gastric cancer. Materials and Methods: The study group was comprised of 316 patients who underwent laparoscopy assisted distal gastrectomy between April 2005 and December 2010. Of these patients, 93 patients whose ages were 65 years or more were compared with 223 patients who were younger. Results: There were no differences in the short term outcome or minor complication rate between the elderly patients and the nonelderly patients. The hospital stay was significantly longer and the major complication rate was significantly higher for the elderly patients compared with nonelderly patients. Conclusions: Laparoscopy assisted distal gastrectomy for early gastric cancer in the elderly patients had comparable operation time and blood loss with the nonelderly group. However, the safety and advantage of laparoscopy assisted distal gastrectomy in the elderly patients need to be further studied in higher volume trials.

Keywords

References

  1. http://kosis.kr/Accessed May 1, 2011
  2. Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal walllifting cholecystectomy. A prospective, randomized study. Surg Endosc 2001;15:477-483. https://doi.org/10.1007/s004640000343
  3. Uemura N, Nomura M, Inoue S, Endo J, Kishi S, Saito K, et al. Changes in hemodynamics and autonomic nervous activity in patients undergoing laparoscopic cholecystectomy: differences between the pneumoperitoneum and abdominal wall-lifting method. Endoscopy 2002;34:643-650. https://doi.org/10.1055/s-2002-33252
  4. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-196. https://doi.org/10.1097/SLA.0b013e3181b13ca2
  5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-213. https://doi.org/10.1097/01.sla.0000133083.54934.ae
  6. Kitamura K, Yamaguchi T, Taniguchi H, Hagiwara A, Yamane T, Sawai K, et al. Clinicopathological characteristics of gastric cancer in the elderly. Br J Cancer 1996;73:798-802. https://doi.org/10.1038/bjc.1996.139
  7. Khan MR, Bari H, Zafar SN, Raza SA. Impact of age on outcome after colorectal cancer surgery in the elderly - a developing country perspective. BMC Surg 2011;11:17. https://doi.org/10.1186/1471-2482-11-17
  8. Simmonds PD, Best L, George S, Baughan C, Buchanan R, Davis C, et al. Surgery for colorectal cancer in elderly patients: a systematic review. The Lancet 2000;16:968-974.
  9. Jeong O, Park YK. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 2011;11:69-77. https://doi.org/10.5230/jgc.2011.11.2.69
  10. Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report--a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg 2010;251:417-420. https://doi.org/10.1097/SLA.0b013e3181cc8f6b
  11. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005;241:232-237. https://doi.org/10.1097/01.sla.0000151892.35922.f2
  12. Hwang SH, Park do J, Jee YS, Kim MC, Kim HH, Lee HJ, et al. Actual 3-year survival after laparoscopy-assisted gastrectomy for gastric cancer. Arch Surg 2009;144:559-564. https://doi.org/10.1001/archsurg.2009.110
  13. Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 2008;248:721-727. https://doi.org/10.1097/SLA.0b013e318185e62e
  14. Kunisaki C, Makino H, Takagawa R, Oshima T, Nagano Y, Ono HA, et al. Efficacy of laparoscopy-assisted distal gastrectomy for gastric cancer in the elderly. Surg Endosc 2009;23:377-383. https://doi.org/10.1007/s00464-008-9949-1
  15. Mochiki E, Ohno T, Kamiyama Y, Aihara R, Nakabayashi T, Asao T, et al. Laparoscopy-assisted gastrectomy for early gastric cancer in young and elderly patients. World J Surg 2005;29:1585-1591. https://doi.org/10.1007/s00268-005-0208-5
  16. Koeda K, Nishizuka S, Wakabayashi G. Minimally invasive surgery for gastric cancer: the future standard of care. World J Surg 2011;35:1469-1477. https://doi.org/10.1007/s00268-011-1051-5
  17. Yasuda K, Sonoda K, Shiroshita H, Inomata M, Shiraishi N, Kitano S. Laparoscopically assisted distal gastrectomy for early gastric cancer in the elderly. Br J Surg 2004;91:1061-1105. https://doi.org/10.1002/bjs.4615
  18. Tokunaga M, Hiki N, Fukunaga T, Miki A, Ohyama S, Seto Y, et al. Does age matter in the indication for laparoscopy-assisted gastrectomy? J Gastrointest Surg 2008;12:1502-1507. https://doi.org/10.1007/s11605-008-0567-y
  19. Hwang SH, Park do J, Jee YS, Kim HH, Lee HJ, Yang HK, et al. Risk factors for operative complications in elderly patients during laparoscopy-assisted gastrectomy. J Am Coll Surg 2009;208:186-192. https://doi.org/10.1016/j.jamcollsurg.2008.10.023
  20. Cho GS, Kim W, Kim HH, Ryu SW, Kim MC, Ryu SY. Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly. Br J Surg 2009;96:1437-1442. https://doi.org/10.1002/bjs.6777
  21. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N; Japanese Laparoscopic Surgery Study Group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 2007;245:68-72. https://doi.org/10.1097/01.sla.0000225364.03133.f8

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