Does age matter in the indication for laparoscopy-assisted gastrectomy?
BACKGROUND
Laparoscopy-assisted gastrectomy (LAG) is being increasingly performed in Japan. However, the indication of LAG in elderly patients who usually have preoperative morbidities and reduced functional capacities still remains unclear.


METHODS
Two hundred eighty-nine patients who underwent LAG at the Cancer Institute Hospital were included in this study. Among them, 240 cases were younger than 75 years old (Y-LAG group), and 49 cases were 75 years old or older (E-LAG group). Early surgical outcomes between the two groups were compared to clarify the feasibility of performing LAG in elderly patients.


RESULTS
The E-LAG group had a higher incidence of preoperative morbidities; however, the frequency of intraoperative and postoperative complications in this group was not significantly different from the Y-LAG group (9% vs 11%). The operation time was significantly shorter, and the number of retrieved lymph nodes was significantly smaller in the E-LAG group compared to the Y-LAG group. However, other early surgical outcomes were not significantly different between two groups.


CONCLUSIONS
LAG proved to be a feasible and safe procedure in elderly patients provided that the patients were selected carefully.
Tokunaga
Masanori
M
Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Hiki
Naoki
N
Fukunaga
Tetsu
T
Miki
Akira
A
Ohyama
Shigekazu
S
Seto
Yasuyuki
Y
Yamaguchi
Toshiharu
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome