Minimally invasive surgery versus open gastrectomy for older patients with gastric cancer: A propensity score-matching analysis

Ann Gastroenterol Surg. 2024 Jul 15;9(1):69-78. doi: 10.1002/ags3.12842. eCollection 2025 Jan.

Abstract

Aim: To compare minimally invasive and open surgery for older patients with gastric cancer.

Methods: This study included 464 consecutive patients with gastric cancer aged ≥75 years who underwent open or laparoscopic gastrectomy at our institution from January 2004 to December 2018. We performed propensity score-matching and compared short- and long-term outcomes between the two groups.

Results: After matching, 332 patients were included in the study (166 in each group). The laparoscopy group had a longer operative time, lesser blood loss, and shorter hospital stays than the open surgery group (all p < 0.020). The laparoscopy group had a lower complication rate than the open surgery group (p = 0.002). No significant differences were noted in the 3-y overall, recurrence-free, and disease-free survival between the groups (all p > 0.200).

Conclusion: Minimally invasive surgery for older patients with gastric cancer may be more beneficial than open gastrectomy in terms of blood loss and hospital stay.

Keywords: elderly; gastrectomy; gastric cancer; general surgery; minimally invasive surgery.