Original Article
Clinical efficacy of laparoscopy-assisted radical gastrectomy for gastric cancer in elderly patients
Guofeng Ji, Fujian Ji, Chong Ma, Xuedong Fang, Youmao Tao
Published 2016-03-14
Cite as Chin J Geriatr, 2016, 35(3): 292-295. DOI: 10.3760/cma.j.issn.0254-9026.2016.03.017
Abstract
ObjectiveTo investigate the safety and feasibility of laparoscopy-assisted radical gastrectomy in elderly gastric cancer patients aged over 70 years.
MethodsClinical data of 222 elderly gastric cancer patients aged over 70 years receiving surgery from January 2010 to January 2015 were retrospectively analyzed. Patients were divided into the laparoscopy-assisted radical gastrectomy group (LAG group, n=106) and the conventional open gastrectomy group (OG group, n=116), depending on the surgery type. General information, surgical parameters, intra-operative blood pressure fluctuations & blood gas analysis, postoperative recovery and complication rates were compared between the two groups.
ResultsThere were no significant differences between the two groups in gender, age, preoperative coexisting diseases, tumor size and location, TNM staging or extent of resection (all P>0.05). Compared with the OG group, blood loss (86.9±38.9) ml vs. (168.8±49.1) ml, t=10.923, P<0.01), operative incision length 〔(9.20±1.55) cm vs. (16.50±2.12) cm, t=8.788, P<0.01〕, time to bowel function recovery 〔(3.20±1.09) d vs. (5.50±1.16) d, t=4.590, P<0.01〕, hospital stay 〔(11.82±3.92) d vs. (16.14±4.69) d, t=2.234, P<0.05〕 and postoperative complications (12.3% vs. 26.4%, χ2=5.186, P<0.05) were reduced in the LAG group. The LAG group had higher levels of partial pressure of carbon dioxide in arterial blood (PaCO2) and lower levels of base excess than the OG group 〔(48.10±5.53) mmHg vs. (40.25±4.66) mmHg, (-7.45±3.72) mmol/L vs. (-3.35±1.98) mmol/L, t=6.908 and 3.619, P<0.01 and 0.05〕. However, there were no significant differences between the two groups in partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2) or hydrogen ion concentration (all P>0.05). No significant differences in operation time or number of retrieved lymph nodes were found between the two groups 〔(196.1±23.4) min vs. (184.2±26.9) min, (28.7±6.5) vs. (27.3±5.6), t=1.174 and 0.515, both P>0.05〕.
ConclusionsLaparoscopy-assisted radical gastrectomy is safe and practical in elderly patients aged over 70 years with gastric cancer and can achieve comparable effects of open radical gastrectomy with less invasiveness and faster recovery.
Key words:
Stomach neoplasms; Laparoscopy; Gastrectomy
Contributor Information
Guofeng Ji
Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China
Fujian Ji
Chong Ma
Xuedong Fang
Youmao Tao
