Koetsu Inoue, MD, PhD1, Tatsuya Ueno, MD, PhD1, Kentaro Shima, MD, PhD1, Shinji Goto, MD, PhD1, Michinaga Takahashi, MD, PhD1, Takanori Morikawa, MD, PhD2, Takeshi Naitoh, MD, PhD2, Hiroo Naito, MD, PhD, FACS1. 1Departmnt of Surgery, South Miyagi Medical Center, 2Department of Surgery, Tohoku University Graduate School of Medicine
Background: As the population age becomes higher, laparoscopy assisted gastrectomy (LAG) is applied to elderly patients as well as young patients. Since laparoscopic surgery is reported to affect respiration and circulation, we should take indication of LAG for elderly patients into consideration carefully. Indication of LAG for elderly patients, however, is still controversial. The aim of this study is to assess the safety and validity of LAG for elderly patients.
Method: Medical records were retrospectively reviewed for 94 patients who underwent LAG for gastric cancer between 2009 and 2016. In this study, patients over 75 years of age were defined as elderly patients. Patients were divided into two groups according to age; group A (age ≥75, n=28), group B (age < 75, n=66). Preoperative characteristics and postoperative outcomes were analyzed. Two-tailed Student’s test and/or Pearson’s chi-square test were used for statistical analysis.
Results: There were no significant differences in male/female ratio and body mass index between two groups. Number of patients whose ASA physical status was ≥3, and/or performance status was ≥3 did not differ. Serum albumin level (4.04 vs 4.3 g/dl, p=0.0045) and hemoglobin (13.0 vs 14.1 g/dl, p=0.006) were significantly lower in group A. The type of procedures were as follows; distal gastrectomy (85.7 vs 75.8 %, p=0.281), total gastrectomy (14.3 vs 22.7 %, p=0.351), proximal gastrectomy (0 vs 1.5 %, p=0.246). Intra-operative blood loss, operating time, and number of harvested lymph nodes did not differ between the two groups. As for postoperative complications such as intra-abdominal abscess (7.4 vs 6.1%, p=0.844), anastomotic leakage (0 vs 3.0%, p=0.352), significant difference was not observed between the two groups. In addition, respiratory and cardiovascular complication was not observed in elderly patients. Incidence of Clavien-Dindo classification ≥ grade 3 (3.6 vs 3.0 %, p=0.891), and postoperative hospital stay (10.5 vs 10.0 days, p=0.985) did not differ.
Conclusion: Short-term outcomes of LAG in elderly patients were not different from those in young patients. These results suggest that LAG could be an alternative operation indicated for patients with comorbidities.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85016
Program Number: P758
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster