Outcomes of laparoscopic total gastrectomy in elderly patients: a propensity score matching analysis

被引：3

作者：

Ebihara, Yuma ^{[1
,2
]}

Kurashima, Yo ^{[1
]}

Watanabe, Yusuke ^{[1
]}

Tanaka, Kimitaka ^{[1
]}

Matsui, Aya ^{[1
]}

Nakanishi, Yoshitsugu ^{[1
]}

Asano, Toshimichi ^{[1
]}

Noji, Takehiro ^{[1
]}

Nakamura, Toru ^{[1
]}

Murakami, Soichi ^{[1
]}

Tsuchikawa, Takahiro ^{[1
]}

Okamura, Keisuke ^{[1
]}

Murakami, Yoshihiro ^{[3
]}

Murakawa, Katsuhiko ^{[4
]}

Nakamura, Fumitaka ^{[5
]}

Morita, Takayuki ^{[6
]}

Okushiba, Shunichi ^{[7
]}

Shichinohe, Toshiaki ^{[1
]}

Hirano, Satoshi ^{[1
]}

机构：

[1] Hokkaido Univ, Fac Med, Dept Gastroenterol Surg 2, Sapporo, Hokkaido, Japan

[2] Hokkaido Univ Hosp, Div Minimally Invas Surg, Sapporo, Hokkaido, Japan

[3] Asahikawa City Hosp, Dept Surg, Asahikawa, Hokkaido, Japan

[4] Obihiro Kosei Gen Hosp, Dept Surg, Obihiro, Hokkaido, Japan

[5] Teine Keijinkai Hosp, Dept Surg, Sapporo, Hokkaido, Japan

[6] Hokkaido Gastroenterol Hosp, Dept Surg, Sapporo, Hokkaido, Japan

[7] Tonan Hosp, Dept Surg, Sapporo, Hokkaido, Japan

来源：

LANGENBECKS ARCHIVES OF SURGERY | 2022年 / 407卷 / 04期

关键词：

Laparoscopic total gastrectomy; Gastric cancer; Elderly patients; Multicenter retrospective study; LONG-TERM SURVIVAL; POSTOPERATIVE COMPLICATIONS; GASTRIC-CANCER; SURGICAL COMPLICATIONS; SURGERY; PROGNOSIS; CLASSIFICATION; RECURRENCE; RESECTION;

D O I：

10.1007/s00423-022-02447-2

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Purpose This study evaluated the short-term outcomes and prognosis after laparoscopic total gastrectomy (LTG) in elderly patients aged >= 80 years in a multicenter retrospective cohort study using propensity score matching. Methods We retrospectively enrolled 440 patients who underwent curative LTG for gastric cancer at six institutions between January 2004 and December 2018. Patients were categorized into an elderly patient group (EG; age >= 80 years) and non-elderly patient group (non-EG; age < 80 years). Patients were matched using the following propensity score covariates: sex, body mass index, American Society of Anesthesiologists physical status, extent of lymph node dissection, and Japanese Classification of Gastric Carcinoma stage. Short-term outcomes and prognoses were compared. Results We identified 37 propensity score-matched pairs. The median operative time was significantly shorter, and postoperative stay was longer in the EG. In terms of postoperative outcomes, the rates of all complications were comparable. The median follow-up period of the EG and non-EG was 11.5 (1-106.4) months and 35.7 (1-110.0) months, respectively; there were significant differences in 5-year overall survival between the two groups (EG, 58.5% vs. non-EG, 91.5%; P = 0.031). However, there were no significant differences in 5-year disease-specific survival (EG, 62.1% vs. non-EG, 91.5%; P = 0.068) or 5-year disease-free survival (EG, 52.9% vs. non-EG, 60.8%; P = 0.132). Conclusions LTG seems to be safe and feasible in elderly patients. LTG had a limited effect on morbidity, disease recurrence, and survival in elderly patients. Therefore, age should not prevent elderly patients from benefitting from LTG.

引用

页码：1461 / 1469

页数：9

共 32 条

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