2016 Volume 49 Issue 10 Pages 953-962
Purpose: To analyze the safety and efficacy of laparoscopic gastrectomy (LG) in elderly people. Methods: We retrospectively analyzed 443 consecutive patients with clinical Stage I gastric cancer who underwent LG at the National Cancer Center Hospital East between 2010 January and 2013 December. Among them, 365 cases consisted of patients younger than 75 years (Group B), and 78 cases consisted of patients 75 years or older (Group A). Clinicopathological factors, perioperative outcomes, and postoperative complications were compared between the two groups. Results: The incidence of comorbidity was higher in Group A than Group B. The operative procedure, operative time and amount of blood loss did not differ, while the proportion of D2 lymph node dissection was lower in Group A than Group B. In addition, the number of lymph node dissections was significantly less in Group A. In terms of postoperative complications, incidence of postoperative complications classified as Clavien-Dindo classification grade II or more were significantly higher in Group A than in Group B. No significant differences were found in complications classified as Clavien-Dindo classification grade III or more. In Group A, respiratory complications were most frequently observed. On the other hand, there was no significant difference in intraabdominal infectious complications (pancreatic fistula, abdominal abscess, anastomotic leakage) between the two groups. Multivariable analysis indicated that BMI ≥24 kg/m2 and operative time ≥210 minutes were independent predictors of postoperative complications, not age. The 3-year overall survival rate in Group A and B was 96% and 98%, respectively, with no significant difference. No recurrence occurred in Group A. Conclusion: LG is safe and effective for elderly patients with early gastric cancer.
