title: Impact of age on early surgical outcomes of laparoscopy-assisted gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer.
abstract: OBJECTIVE
  Although laparoscopy-assisted gastrectomy (LAG) is widely used for the treatment of gastric cancer, its safety and feasibility for elderly patients remains controversial. We herein examined the impact of age on the early surgical outcomes of LAG with suprapancreatic nodal dissection for elderly patients with clinical stage I gastric cancer.
  
  
  METHODS
  This retrospective study included 292 patients undergoing LAG with suprapancreatic nodal dissection for clinical stage I gastric cancer. We divided patients into an elderly group (age ≥ 75 years; n=55) and non-elderly group (age <75 years; n=237). Preoperative conditions, operative findings and postoperative outcomes, including complications, were compared between these two groups.
  
  
  RESULTS
  The elderly group had a higher incidence of co-morbidities (61.8%) and lower forced expiratory volume in 1 second/forced vital capacity (74.8%). Preoperative levels of hemoglobin (Hb) and serum albumin (Alb), as well as the total lymphocyte count (TLC) were lower in the elderly group (p<0.001, <0.001 and =0.018, respectively). No significant differences were observed in intraoperative findings between the two groups. The incidence of overall and surgical complications in the elderly group (21.8% and 14.5%, respectively) did not significantly differ from those in the non-elderly group. The frequency of non-surgical complications in the elderly group (9.1%) was significantly higher (p =0.018), whereas no critical complications or mortality were observed. No significant differences were noted in the severity of complications or hospital courses between the groups.
  
  
  CONCLUSIONS
  LAG with suprapancreatic nodal dissection appears to be safe and feasible for elderly patients with clinical stage I gastric cancer.
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Toshiyuki
authors: T
authors: Kosuga
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan ichikawa@koto.kpu-m.ac.jp.
authors: Daisuke
authors: D
authors: Ichikawa
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Kazuma
authors: K
authors: Okamoto
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Shuhei
authors: S
authors: Komatsu
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Hirotaka
authors: H
authors: Konishi
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Hiroki
authors: H
authors: Takeshita
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Atsushi
authors: A
authors: Shiozaki
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Hitoshi
authors: H
authors: Fujiwara
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Ryo
authors: R
authors: Morimura
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Hisashi
authors: H
authors: Ikoma
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Yasutoshi
authors: Y
authors: Murayama
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Yoshiaki
authors: Y
authors: Kuriu
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Masayoshi
authors: M
authors: Nakanishi
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Chouhei
authors: C
authors: Sakakura
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Eigo
authors: E
authors: Otsuji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000473:pathology; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Gastric cancer; elderly patients; gastrectomy; laparoscopic surgery; laparoscopy-assisted gastrectomy