title: The impact of old age on surgical outcomes of totally laparoscopic gastrectomy for gastric cancer.
abstract: BACKGROUND
  Old age is regarded as the risk factor of major abdominal surgery due to the lack of functional reserve and the increased presence of comorbidities. This study aimed to evaluate the impact of old age on the surgical outcomes of totally laparoscopic gastrectomy for gastric cancer.
  
  
  METHODS
  This study enrolled 389 gastric cancer patients who underwent totally laparoscopic gastrectomy at Hanyang University Guri Hospital and ASAN Medical Center. The patients were classified into two groups according to age as those older than 70 years and those younger than 70 years. Early surgical outcomes such as operation time, postoperative complications, time to first flatus, days until soft diet began, and hospital stay were evaluated.
  
  
  RESULTS
  No patient was converted to open surgery. The two groups differed significantly in terms of overall postoperative complication rate, time to first flatus, days until soft diet began, and hospital stay. The patients who underwent Roux-en-Y gastrojejunostomy differed in incidence of postoperative ileus but not in severe postoperative complication rate.
  
  
  CONCLUSIONS
  The results of this study demonstrated that old age can have an effect on the surgical outcomes of totally laparoscopic gastrectomy. This study especially showed that elderly patients are affected by the return of bowel movement after totally laparoscopic gastrectomy. On the other hand, however, it is presumed that old age has not had a serious impact on surgical outcomes in totally laparoscopic gastrectomy because no difference in the severe postoperative complication rate was observed.
authors.affiliation: Department of Surgery, Hanyang Medical Center, Hanyang University School of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea, md9650@hanyang.ac.kr.
authors.forename: Min Gyu
authors.initials: MG
authors.lastname: Kim
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Kim
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*