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

В 2014-2021 гг. по поводу рака желудка находились на лечении 166 пациентов. Всего было выполнено 149 (89,8%) резекционных операций различных объемов. В остальных случаях были выполнены паллиативные и диагностические операции. Причем, из 40,0% (63/166) пациентов у которых при операции были использованы видеоэндоскопические доступы, в 92,1% (58/63) были выполнены резекционные операции. А при традиционных «открытых» доступах -в 84,5% (79/93).Лапароскопическим доступом была выполнена 21 гастрэктомия и 28 дистальных субтотальных резекций желудка. Лапаротомным доступом -29 гастрэктомий и 30 дистальных субтотальных резекций. Количество послеоперационных осложнений существенно не отличалось. Однако, лапароскопические операции были более эффективны по эффективности резекций и среднему количеству удаленных региональных лимфатических узлов.Ключевые слова: рак желудка, лапароскопические гастрэктомии, лапароскопические резекции желудка. Laparoscopic access was performed for 21 gastrectomies and 28 distal subtotal resections of the stomach. Laparotomic access -29 gastrectomies and 30 distal subtotal resections. The number of postoperative complications did not differ significantly. However, laparoscopic operations were more effective in terms of resection efficiency and the average number of removed regional lymph nodes.

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Major Trauma in Elderly Patients

Savioli

Ceresa

Macedonio

et al. 2021

Journal of Emergencies, Trauma, and Shock

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Introduction: Major trauma is the leading cause of mortality in the world in patients younger than 40 years. However, the proportion of elderly people who suffer trauma has increased significantly. The purpose of this study is to assess the correlation of old age with mortality and other unfavorable outcomes. Methods: We assessed on one hand, anatomical criteria such as ISS values and the number of body regions affected, on the other hand, hemodynamic instability criteria, various shock indices, and Glasgow Coma Scale. Finally, we also evaluated biochemical parameters, such as lactate, BE, and pH values. We conducted a prospective and monocentric observational study of all the patients referred to the Emergency Department of the IRCCS Fondazione Policlinico S. Matteo in Pavia for major trauma in 13 consecutive months: January 1, 2018–January 30, 2019. We compared the elderly population (>75 years) and the younger population (≤75). Results: We included 501 patients, among which 10% were over the age of 75 years. The mortality rate was higher among the older patients than among the younger (4% vs. 1.33%; P = 0.050). Hemodynamic instability was more common in the older patients than in the younger (26% vs. 9%; P < 0.001). More older patients (44%) had an ISS >16, in comparison with 32% of younger patients (P = 0.01). Conclusions: The elderly showed worse outcomes in terms of mortality, hospitalization rate, hemodynamic instability criteria, and anatomical and biochemical parameters.

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

Abstract: LADG is a safe and less invasive treatment for gastric cancer in elderly patients, who have a greater incidence of comorbidity.

Cited by 4 publications

References 31 publications

Dismal prognosis of elderly gastric cancer patients who underwent gastrectomy with American Society of Anesthesiologists (ASA) 3

Dismal prognosis of elderly gastric cancer patients who underwent gastrectomy with American Society of Anesthesiologists (ASA) 3

Непосредственные Результаты Лапароскопических Резекций Желудка И Гастрэктомий При Раке

Major Trauma in Elderly Patients

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