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Surgical risk and benefits of laparoscopic surgery for elderly patients with gastric cancer: a multicenter prospective cohort study.
Surgical risk and benefits of laparoscopic surgery for elderly patients with gastric cancer: a multicenter prospective cohort study.
- Source :
-
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2019 Jul; Vol. 22 (4), pp. 845-852. Date of Electronic Publication: 2018 Dec 11. - Publication Year :
- 2019
-
Abstract
- Background: Laparoscopic gastrectomy (LG) might have greater clinical benefits for elderly patients as less invasive surgery; however, there is still little evidence to support its benefit. We evaluated the surgical outcomes of elderly patients in a nationwide prospective cohort study.<br />Methods: One hundred and sixty-nine participating institutions were identified by stratified random sampling, and were adjusted for hospital volume, type and location. During 1 year from 2014 to 2015, consecutive patients who underwent gastrectomy for gastric cancer were prospectively enrolled. 'Elderly' was defined as ≥ 75 years of age, based on the prevalence of comorbidities and the activities of daily living of patients of this age. We compared the surgical outcomes of LG to those of open gastrectomy (OG) in non-elderly and elderly patients. The primary outcome was the incidence of severe morbidities (Grade ≥ 3).<br />Results: Eight thousand nine hundred and twenty-seven patients were enrolled [non-elderly, n = 6090 (OG, n = 2602; LG, n = 3488); elderly, n = 2837 (OG, n = 1471; LG, n = 1366)]. Grade ≥ 3 complications occurred in 161 (10.9%) patients who underwent OG and 98 (7.2%) who underwent LG (p < 0.001). After adjusting for confounding factors, we confirmed that laparoscopic surgery was not an independent risk factor (odds ratio = 0.81, 0.60-1.09). OG was associated with a significantly longer median length of postoperative stay in comparison to LG (16 versus 12 days, p < 0.001). There were no significant differences in the incidence of other postoperative comorbidities.<br />Conclusion: The safety of LG in elderly patients was demonstrated. LG shortened the length of postoperative hospital stay.
- Subjects :
- Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Stomach Neoplasms pathology
Survival Rate
Treatment Outcome
Activities of Daily Living
Gastrectomy mortality
Laparoscopy mortality
Length of Stay statistics & numerical data
Postoperative Complications
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1436-3305
- Volume :
- 22
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
- Publication Type :
- Academic Journal
- Accession number :
- 30539321
- Full Text :
- https://doi.org/10.1007/s10120-018-0898-7