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Laparoscopy-assisted gastrectomy in the elderly: experience from a UK centre
A Tandon1, I Rajendran1, M Aziz1
1Department of General Surgery, Aintree University Hospital , Liverpool , UK.
Annals of the Royal College of Surgeons of England
|November 22, 2016
Summary
Laparoscopy-assisted gastrectomy is a safe and effective treatment for elderly patients with gastric cancer, showing similar complication rates and better recurrence rates compared to younger patients. Further research is needed to confirm these findings.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Geriatric Medicine
Background:
- Gastric cancer is prevalent in the UK elderly population, particularly those over 75.
- Limited evidence exists on managing gastric cancer in Western elderly patients.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopy-assisted gastrectomy in elderly patients.
- To compare outcomes between elderly and non-elderly patients undergoing this procedure.
Main Methods:
- Retrospective review of 60 laparoscopy-assisted gastrectomies (total and distal) from 2005-2015.
- Inclusion criteria: patients aged 70 years or older for the elderly group.
- Comparison of surgical complications, mortality, operation time, hospital stay, and recurrence rates.
Main Results:
- No significant differences in overall complications, mortality, operation time, or hospital stay between elderly and non-elderly groups.
- Higher, though not statistically significant, risk of anastomotic leaks and surgical complications in patients over 70.
- Significantly lower recurrence rate within 3 years in the elderly group (P = 0.002).
- No significant difference in survival between the groups (P = 0.619).
Conclusions:
- Laparoscopy-assisted gastrectomy is a safe and feasible surgical option for elderly gastric cancer patients.
- Elderly patients may experience lower recurrence rates after this procedure.
- Further prospective, randomized studies are recommended to include quality of life data.
