Laparoscopy-assisted distal gastrectomy is feasible also for elderly patients aged 80 years and over: effectiveness and long-term prognosis

Yoshida, Misao; Koga, Shigehiro; Ishimaru, Kei; Yamamoto, Yuji; Matsuno, Yusuke; Akita, Satoshi; Kuwabara, Jun; Tanigawa, Kazufumi; Watanabe, Yuji

doi:10.1007/s00464-017-5493-1

Cited by 27 publications

(26 citation statements)

References 21 publications

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“…Our long‐term outcomes demonstrated no significant differences in either OS or RFS between the two groups. LG has been shown to be a safe treatment for gastric cancer in elderly patients , and we agree that LG for EGC is a reasonable and valid procedure. However, the clinical significance of LN dissection for EGC is still controversial .…”

Section: Discussionsupporting

confidence: 68%

“…LG has been shown to be a safe treatment for gastric cancer in elderly patients (9,22), and we agree that LG for EGC is a reasonable and valid procedure. However, the clinical significance of LN dissection for EGC is still controversial (27-29).…”

Section: Discussionsupporting

confidence: 68%

“…LG has many advantages for patients with EGC, including good cosmesis, minimal postoperative pain, low operative stress, early postoperative recovery, early meal ingestion, a short postoperative hospital stay, and improved quality of life (17)(18)(19). The results of the present study indicate that LG for EGC is safe and feasible for elderly patients (9,20).…”

Section: Discussionmentioning

confidence: 61%

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Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

Yasukawa

Kadokawa

Kato

et al. 2018

Asian J Endoscop Surgery

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 61%

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Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

Yasukawa

Kadokawa

Kato

et al. 2018

Asian J Endoscop Surgery

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“…The average age of patients with gastric cancer (GC) undergoing gastrectomy is rising with increased life expectancy. Elderly patients usually have various comorbidities such as cardiovascular diseases, decreased respiratory function, and renal dysfunction (1,2). It has been reported that the rate of morbidity and mortality is higher in elderly patients than in younger adults, and when postoperative complications occur in elderly patients, their daily life activity decreases due to delay in wound healing, decrease of muscular mass, and long-term hospitalization (3,4).…”

mentioning

confidence: 99%

The Preoperative Geriatric Nutritional Risk Index Predicts Postoperative Complications in Elderly Patients with Gastric Cancer Undergoing Gastrectomy

Kushiyama

Sakurai

Kubo

et al. 2018

In Vivo

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Background/Aim: The relationship between the preoperative Geriatric Nutritional Risk Index (GNRI) and morbidity of patients with gastric cancer (GC) undergoing gastrectomy has not yet been reported. Our study aimed to investigate whether preoperative GNRI is associated with shortterm outcomes in elderly patients with GC. Patients and Methods: This study enrolled 348 elderly patients with GC who were more than 75 years old and underwent curative gastrectomy for GC at our Institution between January 2006 and December 2015. GNRI was invoked to stratify patients as high (GNRI≥92; n=190) or low (GNRI<92; n=158) GNRI nutritional status. The clinicopathologic features and short-term outcomes were compared. Results: In multivariate analysis, low GNRI emerged as an independent predictor of postoperative complications (Clavien Dindo classification grade II≤). Low GNRI demonstrated significantly more frequent extra-surgical complications than high GNRI. Significantly more patients with low GNRI suffered from postoperative pneumoniae than patients with high GNRI (p=0.013). On the other hand, the incidence of surgical field complications such as leakage, pancreatic fistula and intraabdominal abscess did not differ significantly between the groups. Conclusion: GNRI is useful in predicting postoperative complications of elderly patients with GC undergoing gastrectomy. Preoperative GNRI has merit as a gauge of postoperative complications in the extrasurgical field, especially pneumonia. There was no relationship between preoperative GNRI and surgical field complications in this setting.

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“…Since the first laparoscopic gastrectomy was described in 1992 [1] , the safety and feasibility of laparoscopic gastrectomy have already been demonstrated in the treatment of early gastric cancer [2,3] and several advantages of laparoscopic gastrectomy were reported in comparison with open gastrectomy, such as postoperative recovery and shorter hospital stay [4,5] . Due to being less invasive, laparoscopic gastrectomy was successfully performed in elderly patients and obese patients with an acceptable complication rate and prognosis [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Intracorporeal hemi-hand-sewn technique for Billroth-I gastroduodenostomy after laparoscopic distal gastrectomy: comparative analysis with laparoscopy-assisted distal gastrectomy

Ohmura¹,

Suzuki²,

Kotani³

et al. 2019

MIS

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How to cite this article: Ohmura Y, Suzuki H, Kotani K, Teramoto A. Intracorporeal hemi-hand-sewn technique for Billroth-I gastroduodenostomy after laparoscopic distal gastrectomy: comparative analysis with laparoscopy-assisted distal gastrectomy.Mini-invasive Surg 2019;3:4. http://dx. AbstractAim: The purpose of this study was to evaluate the clinical feasibility and efficacy of the intracorporeal hemi-hand-sewn (IC-HHS) technique for Billroth-I gastroduodenostomy in comparison with extracorporeal total hand-sewn (EC-THS) anastomosis. We also examined the size of resected specimens in each procedure. Methods:The number of enrolled cases of EC-THS and IC-HHS anastomosis groups were 85 and 110 cases, respectively. Perioperative data and the measured sizes of resected specimens were analyzed. Results:Operation time in the IC-HHS group was significantly longer than the EC-THS group (234.8 min vs. 275.0 min, P < 0.01), whereas intraoperative blood loss was less in the IC-HHS group (48.4 mL vs. 25.4 mL, P = 0.03). There were no procedure-related complications in the IC-HHS group. The greater curvature of the EC-THS group was significantly shorter than the IC-HHS group (214.6 mm vs. 228.7 mm, P < 0.01). There was no correlation between body mass index (BMI) and the length of the greater curvature in the IC-HHS group (r = 0.07, P = 0.47), but in the EC-THS group, the length of the greater curvature tends to shorten as BMI increases (r = -0.45, P < 0.01).Conclusion: IC-HHS technique for Billroth-I gastroduodenostomy revealed feasible with acceptable operation time and postoperative outcome. Another advantage of total laparoscopic distal gastrectomy that intracorporeal transection can facilitate is to ensure an adequate proximal margin, especially in obese middle gastric cancer patients.

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Laparoscopy-assisted distal gastrectomy is feasible also for elderly patients aged 80 years and over: effectiveness and long-term prognosis

Abstract: LADG seems to be safe and effective even for elderly patients, and their prognosis was satisfactory. However, careful monitoring for cardiovascular and pulmonary disease should be observed during the follow-up period.

Cited by 27 publications

References 21 publications

Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

Safety and feasibility of laparoscopic gastrectomy accompanied by D1+ lymph node dissection for early gastric cancer in elderly patients

The Preoperative Geriatric Nutritional Risk Index Predicts Postoperative Complications in Elderly Patients with Gastric Cancer Undergoing Gastrectomy

Intracorporeal hemi-hand-sewn technique for Billroth-I gastroduodenostomy after laparoscopic distal gastrectomy: comparative analysis with laparoscopy-assisted distal gastrectomy

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