Laparoscopy-assisted gastrectomy in patients older than 80

Abstract

Background: With the changing age distribution, the number of elderly patients with gastric cancer is anticipated to increase. This study evaluated the morbidity and mortality of laparoscopy-assisted gastrectomy (LAG) in patients older than 80.

Methods and methods: A total of 74 patients who underwent LAG for gastric cancer were assigned to two groups: an elderly group (70-79 y; n=56) and a very elderly group (older than 80; n=18). Preoperative comorbidity, operative results, and postoperative outcome were retrospectively analyzed.

Results: In terms of concurrent illness, cardiovascular disease was significantly more frequent in the very elderly group than in the elderly group (P=0.042). Percent vital capacity (%VC) and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio were lower in the very elderly group than in the elderly group (%VC; 97.9% +/- 18.8% versus 109.0% +/- 18.0%, P=0.035, FEV(1)/FVC ratio; 68.0% +/- 7.8% versus 73.5% +/- 8.7%, P=0.026). Preoperative hemoglobin was significantly lower in the very elderly group than in the elderly group (11.8+/-2.0 versus 13.1+/-2.0, P=0.026). Incidence of postoperative complications and postoperative hospital stay were similar in both groups. No significant differences in time to first flatus or time to fever resolution (<37 degrees C) were noted between the two groups.

Conclusion: Our analysis revealed that LAG can be safely performed in patients older than 80, with complication rates and operation outcomes similar to those for patients aged 70-79.