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Minimally invasive surgery as a treatment option for gastric cancer in the elderly: comparison with open surgery for patients 80 years and older

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Author(s)
In Gyu KwonIn ChoAli GunerHyoung-il KimSung Hoon NohWoo Jin Hyung
Keimyung Author(s)
Kwon, In Gyu
Department
Dept. of Surgery (외과학)
Journal Title
Surgical Endoscopy
Issued Date
2015
Volume
29
Issue
8
Keyword
Minimally invasive surgeryGastric cancerElderlyGastrectomyLaparoscopyOctogenarian
Abstract
Background As life expectancy is increasing, the use of
minimally invasive surgery (MIS) in the elderly is gaining
interest. The aim of this study was to identify the impact of
minimally invasive gastrectomy by comparing the procedure
to open surgery in octogenarians. In addition, we also
evaluated the role of gastrectomy in elderly gastric cancer
patients by assessing long-term outcomes.
Methods We retrospectively analyzed data from 99 gastric
cancer patients aged 80 years or older, who underwent
gastrectomy by either MIS or open surgery from 2005 to
2010. Patient characteristics, operative outcomes, pathologic
results, morbidity, mortality, and follow-up data
(including survival) were compared.
Results Thirty patients underwent gastrectomy with
MIS (19 laparoscopic and 11 robotic) and 69 patients
underwent open gastrectomy. MIS demonstrated significantly
less blood loss, lower analgesic consumption,
faster time to first flatus and soft diet, and a shorter postoperative
hospital stay. Multivariate analysis revealed
that the type of operation had no effect on the occurrence
of complications. There were two postoperative
mortalities, both in the open group. Excluding these
patients, the overall and disease-specific 5-year survival
rates were 57.4 and 70.0 %, respectively. The overall
(MIS 70.0 %; open 52.0 %) and disease-specific (MIS
81.8 %; open 65.1 %) 5-year survival rates were similar
for the two groups. When we analyzed the 85 patients
underwent curative resection only, the overall (MIS
71.4 %; open 58.4 %) and disease-specific (MIS 84.1 %;
open 73.6 %) 5-year survival rates were similar for the
two groups.
Conclusions MIS for gastric cancer may be performed
safely and maintains the advantages of minimal invasiveness,
even in extremely old patients. Furthermore, gastrectomy
by either by MIS or open surgery can reduce
gastric cancer-related deaths, even in patients 80 years or
older.
Keimyung Author(s)(Kor)
권인규
Publisher
School of Medicine
Citation
In Gyu Kwon et al. (2015). Minimally invasive surgery as a treatment option for gastric cancer in the elderly: comparison with open surgery for patients 80 years and older. Surgical Endoscopy, 29(8), 2321–2330. doi: 10.1007/s00464-014-3955-2
Type
Article
ISSN
0930-2794
Source
https://link.springer.com/article/10.1007%2Fs00464-014-3955-2
DOI
10.1007/s00464-014-3955-2
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33003
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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