Laparoscopy-assisted gastrectomy in patients older than 80.
BACKGROUND
With the changing age distribution, the number of elderly patients with gastric cancer is anticipated to increase. This study evaluated the morbidity and mortality of laparoscopy-assisted gastrectomy (LAG) in patients older than 80.


METHODS
A total of 74 patients who underwent LAG for gastric cancer were assigned to two groups: an elderly group (70-79 y; n=56) and a very elderly group (older than 80; n=18). Preoperative comorbidity, operative results, and postoperative outcome were retrospectively analyzed.


RESULTS
In terms of concurrent illness, cardiovascular disease was significantly more frequent in the very elderly group than in the elderly group (P=0.042). Percent vital capacity (%VC) and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio were lower in the very elderly group than in the elderly group (%VC; 97.9% +/- 18.8% versus 109.0% +/- 18.0%, P=0.035, FEV(1)/FVC ratio; 68.0% +/- 7.8% versus 73.5% +/- 8.7%, P=0.026). Preoperative hemoglobin was significantly lower in the very elderly group than in the elderly group (11.8+/-2.0 versus 13.1+/-2.0, P=0.026). Incidence of postoperative complications and postoperative hospital stay were similar in both groups. No significant differences in time to first flatus or time to fever resolution (<37 degrees C) were noted between the two groups.


CONCLUSIONS
Our analysis revealed that LAG can be safely performed in patients older than 80, with complication rates and operation outcomes similar to those for patients aged 70-79.
Yamada
Hiroyuki
H
Department of Esophagogastric Surgery, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. h-yamada.srg2@tmd.ac.jp
Kojima
Kazuyuki
K
Inokuchi
Mikito
M
Kawano
Tatsuyuki
T
Sugihara
Kenichi
K
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001927:Brain Diseases / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000145:classification; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014797:Vital Capacity
D006454:Hemoglobins