Muneharu Fujisaki1, Toshihiko Shinohara2, Nobuyoshi Hanyu1, Susumu Kawano1, Yujiro Tanaka1, Atsushi Watanabe1, Katsuhiko Yanaga3. 1. Department of Surgery, Machida Municipal Hospital, 2-15-41 Asahicho, Machida, Tokyo, 194-0023, Japan. 2. Department of Surgery, Machida Municipal Hospital, 2-15-41 Asahicho, Machida, Tokyo, 194-0023, Japan. shinohara@jikei.ac.jp. 3. Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
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.
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.
Entities:
Keywords:
American Society of Anesthesiologists; Charlson comorbidity index; Elderly patients; Gastric cancer; Laparoscopic surgery
Authors: R Pugliese; D Maggioni; F Sansonna; G C Ferrari; A Forgione; A Costanzi; C Magistro; J Pauna; S Di Lernia; D Citterio; C Brambilla Journal: Eur J Surg Oncol Date: 2008-03-14 Impact factor: 4.424
Authors: Su Mi Kim; Ho Geun Youn; Ji Yeong An; Yoon Young Choi; Sung Hoon Noh; Seung Jong Oh; Tae Sung Sohn; Sung Kim Journal: J Gastrointest Surg Date: 2018-03-16 Impact factor: 3.452