Objective: To investigate the clinical efficacy of laparoscopy-assisted radical gastrectomy in elderly patients with gastric cancer.
Methods: Clinical data of 214 patients with gastric cancer were analyzed retrospectively, who underwent laparoscopy-assisted radical gastrectomy in the Department of Minimally Invasive Gastrointestinal Surgery at Beijing Cancer Hospital between May 2009 and December 2012. The patients were divided into two groups, consisting of elderly group(age ≥70 years old, n=53) and non-elderly group(age <70 years old, n=161). The operative procedure and postoperative recovery were compared between the two groups.
Results: Elderly group had a worse ASA score as compared to non-elderly group with significant difference(P<0.05). Among the elderly, the incidences of concomitant diseases, such as hypertension and diabetes, were significantly higher. No significant differences were observed in terms of duration of operation, blood loss, blood transfusion rate, conversion to laparotomy, time to first flatus and postoperative hospital stay between the two groups(P>0.05). The mean number of retrieved lymph nodes in elderly group was less than that of non-elderly group (26.4±9.7 vs. 30.0±12.4), but whose difference was not significant(P>0.05). There were no significant differences between two groups with respect to postoperative complications (30.2% vs. 19.9%, P>0.05) and surgery-related complications(18.9% vs. 18.0%, P>0.05), but the incidence of medical complications was higher in elderly group (11.3% vs. 1.9%, P<0.05). Furthermore, the perioperative mortality was 1.9% and 0.6% respectively in elderly and non-elderly groups without significant difference(P>0.05).
Conclusion: Associated with more concomitant diseases, the elderly had higher risk of medical complications after operation, while laparoscopy-assisted radical gastrectomy does not increase the risk of surgery-related complications in elderly patients.