Risk factors for operative complications in elderly patients during laparoscopy-assisted gastrectomy

J Am Coll Surg. 2009 Feb;208(2):186-92. doi: 10.1016/j.jamcollsurg.2008.10.023. Epub 2008 Dec 18.

Abstract

Background: We evaluated the feasibility of laparoscopy-assisted gastrectomy in elderly patients with gastric cancer.

Study design: We performed a retrospective analysis of 632 patients who underwent laparoscopy-assisted gastrectomy from May 2003 to December 2007 at Seoul National University Bundang Hospital. Postoperative complication rates were compared between patients older and younger than 70 years of age.

Results: Of the 632 patients, 515 (81.5%) were younger than 70 years and 117 (18.5%) were aged 70 years or older. Significant differences in the prevalence of cardiovascular disease and hypertension were observed in patients older than 70 years (p < 0.05). Although the overall complication rates of the patients younger and older than 70 years were 12.6% and 17.9%, respectively, there was no statistically significant difference between groups (p=0.12). Multiple logistic regression analysis revealed that comorbidities with hypertension or with liver cirrhosis were the only variables that correlated independently with postoperative complications.

Conclusions: Complications after laparoscopy-assisted gastrectomy for patients older than 70 years of age with gastric cancer were similar to those of younger patients. But a careful approach is required when patients older than 70 years of age have hypertension or liver cirrhosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Comorbidity
  • Feasibility Studies
  • Female
  • Gastrectomy / adverse effects*
  • Gastrectomy / instrumentation
  • Gastrectomy / methods*
  • Humans
  • Hypertension / epidemiology
  • Korea / epidemiology
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods*
  • Liver Cirrhosis / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome