Efficacy of totally laparoscopic distal gastrectomy for gastric cancer in elderly patients

Abstract

Abstract. Elderly patients are often considered as high-risk for major abdominal surgery due to reduced functional reserve and increased comorbidities. We herein evaluated the efficacy of totally laparoscopic distal gastrectomy (TLDG) in elderly patients with gastric cancer by measuring the postoperative systemic responses and postoperative analgesic consumption. A total of 102 patients with gastric cancer [57 who underwent TLDG and 45 who underwent laparoscopy-assisted distal gastrectomy (LADG)] were enrolled in this study. The patients were classified as elderly (aged ≥75 years) and non-elderly (aged <75 years) groups. The surgical outcome and postoperative analgesic consumption were evaluated. The elderly group exhibited a higher incidence of comorbidities and a longer postoperative hospital stay compared with those of younger patients, although there was no difference in the incidence of postoperative complications. In addition, the total consumption of additional analgesics until postoperative day 5 in patients who underwent TLDG was significantly lower compared with that in patients who underwent LADG in the elderly group; there was no such difference in the non-elderly group. The results suggested that TLDG was better for the management of postoperative pain in elderly patients with gastric cancer, who exhibit the highest mortality rates in the adult surgical population.

Laparoscopy-assisted Distal Gastrectomy for Gastric Cancer in Elderly Patients: Surgical Outcomes and Prognosis

“…Consistent with the present study, they found no severe perioperative complications caused by carbon dioxide pneumoperitoneum in elderly patients who had significantly higher ASA scores. Several studies have also reported that laparoscopic gastrectomy is safe for elderly as well as for non-elderly patients in short-term surgical outcome (10,11,(33)(34)(35). In addition, we found no significant differences in intraoperative blood loss, operative time and complications after surgery between the elderly and non-elderly groups.…”

Laparoscopic gastrectomy for elderly patients with gastric cancer

“…Patients who were more than 70 years old were categorized as elderly patients in 5 studies, [ 19 , 21 , 23 , 26 , 28 ] more than 65 years old in one studies, [ 25 ] and more than 75 years old in 5 studies. [ 18 , 20 , 22 , 24 , 27 ] According to the Newcastle-Ottawa Quality Assessment Scale, all 11 studies were achieved no less than 6 stars, Table 2 .…”

<p>Combining the Fibrinogen-to-Pre-Albumin Ratio and Prognostic Nutritional Index (FPR-PNI) Predicts the Survival in Elderly Gastric Cancer Patients After Gastrectomy</p>

“…As we know, elderly GC patients, who are often malnourished and in a low state of immunity, with various comorbid conditions, have a high incidence of death from other diseases after surgeries. 4 , 5 , 39 - 41 Previous studies showed that the OS of elderly patients with a lower PNI score was shorter than the young. 42 The PNI could be a significant independent prognostic factor for predicting OS in elderly GC patients.…”