[Surgical treatment of gastric cancer in the aged]

The present status of surgical treatment for gastric cancer in the aged was reviewed. The incidence among the aged in the overall operated patients with gastric cancer has increased yearly and recently has reached approximately 35%. The incidence of early gastric cancer in the aged has increased 40% in recent times. Pulmonary failure and anastomotic leak of the alimentary tract are the most common post-operative complications in the aged; these easily lead to the development of multiple organ failure with high mortality. Precise pre-operative evaluation of functional disorder in each organ and pre-, post-operative nutritional and transfusional support is indispensable to overcome these complications. Surgeons are required to perform appropriate surgical maneuvers with minimum operation time and minimum blood loss with full consideration for the adequate surgical indication in accordance with both the spread of the cancer and the general condition of the aged patient. Mental care to avoid post-operative mental disorders is also crucial.