title: Impact of age and comorbidity on the short-term surgical outcome after laparoscopy-assisted distal gastrectomy for adenocarcinoma.
abstract: The aim of this study was to determine whether age and comorbidity are valuable risk factors of the short-term surgical outcome after laparoscopy-assisted distal gastrectomy (LADG) in patients with adenocarcinoma. A series of 387 patients who underwent LADG at three university hospitals  between March 2006 and December 2010 were retrospectively studied. To compare the short-term surgical outcomes of LADG of elderly patients with those of younger patients, patients were categorized into an elderly group (older than 70 years of age) and a younger group (70 years of age or younger).  For another comparative analysis to identify risk factors of postoperative complications after LADG, patients were categorized into two groups: those with complications and those without complications. With the exception of sex ratio and comorbidity rate, two age groups were nonsignificantly  different in terms of demographic, operative, pathologic, and short-term surgical outcome data. Our data support the safety and feasibility of LADG in elderly patients. However, our data show that comorbidity is an important predictor of postoperative systemic complications after LADG. Patients  with an age-adjusted Charlson comorbidity index (CCI) of 3 or greater were found to be at a greater risk of developing systemic complications, which suggests that age-adjusted CCI is a useful predictor of systemic complications after LADG and that it could be used routinely for the perioperative  care of aged patients with comorbidity. We recommend age-adjusted CCI be used in comparative clinical research studies on the surgical outcomes across surgeons and hospitals.
authors: Korea University School of Medicine, Seoul, Korea.
authors: Han-A
authors: HA
authors: Park
authors: Seong-Heum
authors: SH
authors: Park
authors: Sung-Il
authors: SI
authors: Cho
authors: You-Jin
authors: YJ
authors: Jang
authors: Jong-Han
authors: JH
authors: Kim
authors: Sung-Soo
authors: SS
authors: Park
authors: Young-Jae
authors: YJ
authors: Mok
authors: Chong-Suk
authors: CS
authors: Kim
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome