M. Kasuya, S. Sakuramoto, K. Aratani, M. Chuman, Y. Miyawaki, H. Gunji, H. Sato, S. Yamaguchi, K. Okamoto, I. Koyama. Saitama Medical University International Medical Center
Introduction: The aim of this study was to assess the safety and efficacy of laparoscopic and open distal gastrectomy (LDG and ODG) each other in elderly patients with gastric cancer compared with the short-term outcome in the nonelderly.
Materials & Methods: We reviewed 439 patients who underwent distal gastrectomy between January 2013 and October 2016. Of these, LDG was performed 280 patients and ODG was performed 159. We compared elderly patients (aged 75 years or more) with younger patients in each operative procedure. (LDG: elderly 71, younger 209; ODG: elderly 73, younger 86) Preoperative comorbidity and surgical results were analyzed. Multivariate analysis was performed to detect predictive factors for postoperative complications.
Results: In both LDG and ODG groups, the operative time and amount of blood loss did not differ, while comorbidity was more common in elderly patients than in the nonelderly, and there were fewer retrieved lymph nodes in elderly patients. The incidence of all postoperative complications did not differ between both groups in each procedure, and there were no significant differences in the time to first flatus or postoperative hospital stay. However, in terms of specific postoperative complications, respiratory complications were more frequently observed in eldery group with ODG significantly(p=0.034), while not with LDG group. In multivariable analysis, age was not independent predictor of postoperative complications.
Conclusion: ODG for eldery patients requires attention particularly in postoperative respiratory complications. LDG is a safe and less invasive treatment for gastric cancer in elderly patients who have greater comorbidity.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86226
Program Number: P738
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster