Laparoscopic gastrectomy for gastric cancer in the elderly patients
Background This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure. Methods We retrospectively in...
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| Veröffentlicht in: | Surgical endoscopy 2016-04, Vol.30 (4), p.1380-1387 |
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| creator | Fujisaki, Muneharu Shinohara, Toshihiko Hanyu, Nobuyoshi Kawano, Susumu Tanaka, Yujiro Watanabe, Atsushi Yanaga, Katsuhiko |
| description | Background
This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure.
Methods
We retrospectively investigated 208 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and September 2014. After excluding 15 patients with unusual medical histories or surgical treatments, 193 were selected for this cohort study. We divided the patients into two cohorts: elderly patients (≥75 years old) and non-elderly patients ( |
| doi_str_mv | 10.1007/s00464-015-4340-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1775382141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3992426341</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-282742f362b7cecbddb39c0ebce7fbbbad5d4041349e9ce8e7fcf1646c67761e3</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMo7rr6A7xIwYuXajJJmvYoi1-w4EXPIUmna5d-mXQP--_N0lVE8DTM5Jl3wkPIJaO3jFJ1FygVmUgpk6nggqbyiMyZ4JACsPyYzGnBaQqqEDNyFsKGRrxg8pTMIGPAOVdzslyZwfg-uH6oXbI2YfToxr7dJVXvpz7Onekc-qTukvEDE2xK9M0uGcxYYzeGc3JSmSbgxaEuyPvjw9vyOV29Pr0s71epkwBjCjkoARXPwCqHzpal5YWjaB2qylprSlkKKhgXBRYO8zh1FctE5jKlMoZ8QW6m3MH3n1sMo27r4LBpTIf9NmimlOQ5sBixINd_0E2_9V383Z4SilOQECk2US4aCB4rPfi6NX6nGdV7w3oyrKNhvTesZdy5OiRvbYvlz8a30gjABIT41K3R_zr9b-oX_zWGIw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1774730252</pqid></control><display><type>article</type><title>Laparoscopic gastrectomy for gastric cancer in the elderly patients</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Fujisaki, Muneharu ; Shinohara, Toshihiko ; Hanyu, Nobuyoshi ; Kawano, Susumu ; Tanaka, Yujiro ; Watanabe, Atsushi ; Yanaga, Katsuhiko</creator><creatorcontrib>Fujisaki, Muneharu ; Shinohara, Toshihiko ; Hanyu, Nobuyoshi ; Kawano, Susumu ; Tanaka, Yujiro ; Watanabe, Atsushi ; Yanaga, Katsuhiko</creatorcontrib><description>Background
This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure.
Methods
We retrospectively investigated 208 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and September 2014. After excluding 15 patients with unusual medical histories or surgical treatments, 193 were selected for this cohort study. We divided the patients into two cohorts: elderly patients (≥75 years old) and non-elderly patients (<74 years old). We compared these cohorts with respect to clinicopathological characteristics and intraoperative and postoperative parameters.
Results
The overall complication rates were 11.4 % (8 of 70 patients) in the elderly cohort and 8.1 % (10 of 123 patients) in the non-elderly cohort (
P
= 0.449). In a univariate analysis, Charlson comorbidity index (CCI) of ≥3, American Society of Anesthesiologists (ASA) score of 3, operative time of ≥330 min, and intraoperative blood loss of ≥50 ml were found to correlate significantly with postoperative complications. In a multivariate analysis, CCI of ≥3 (
P
= 0.034), ASA score of 3 (
P
= 0.019), and intraoperative blood loss of ≥50 ml (
P
= 0.016) were found to be independent risk factors of postoperative complications. In contrast, age was not found to significantly affect the risk of postoperative complications.
Conclusions
Laparoscopic gastrectomy for gastric cancer can be successfully performed in elderly patients with an acceptable complication rate. This study suggested that high CCI, ASA score, and intraoperative blood loss volume were identified as independent predictors of postoperative complications after laparoscopic gastrectomy for gastric cancer.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-015-4340-5</identifier><identifier>PMID: 26123337</identifier><language>eng ; jpn</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aftercare ; Aged ; Aged, 80 and over ; Cohort analysis ; Comorbidity ; Dissection ; Female ; Gastrectomy - methods ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Hospitals ; Humans ; Incidence ; Japan - epidemiology ; Laparoscopy ; Laparoscopy - methods ; Laparotomy ; Lymphatic system ; Male ; Medical personnel ; Medicine ; Medicine & Public Health ; Middle Aged ; Operative Time ; Postoperative Complications - epidemiology ; Proctology ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms - mortality ; Stomach Neoplasms - surgery ; Surgery ; Surgical outcomes ; Survival Rate - trends</subject><ispartof>Surgical endoscopy, 2016-04, Vol.30 (4), p.1380-1387</ispartof><rights>Springer Science+Business Media New York 2015</rights><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-282742f362b7cecbddb39c0ebce7fbbbad5d4041349e9ce8e7fcf1646c67761e3</citedby><cites>FETCH-LOGICAL-c522t-282742f362b7cecbddb39c0ebce7fbbbad5d4041349e9ce8e7fcf1646c67761e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-015-4340-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-015-4340-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26123337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fujisaki, Muneharu</creatorcontrib><creatorcontrib>Shinohara, Toshihiko</creatorcontrib><creatorcontrib>Hanyu, Nobuyoshi</creatorcontrib><creatorcontrib>Kawano, Susumu</creatorcontrib><creatorcontrib>Tanaka, Yujiro</creatorcontrib><creatorcontrib>Watanabe, Atsushi</creatorcontrib><creatorcontrib>Yanaga, Katsuhiko</creatorcontrib><title>Laparoscopic gastrectomy for gastric cancer in the elderly patients</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure.
Methods
We retrospectively investigated 208 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and September 2014. After excluding 15 patients with unusual medical histories or surgical treatments, 193 were selected for this cohort study. We divided the patients into two cohorts: elderly patients (≥75 years old) and non-elderly patients (<74 years old). We compared these cohorts with respect to clinicopathological characteristics and intraoperative and postoperative parameters.
Results
The overall complication rates were 11.4 % (8 of 70 patients) in the elderly cohort and 8.1 % (10 of 123 patients) in the non-elderly cohort (
P
= 0.449). In a univariate analysis, Charlson comorbidity index (CCI) of ≥3, American Society of Anesthesiologists (ASA) score of 3, operative time of ≥330 min, and intraoperative blood loss of ≥50 ml were found to correlate significantly with postoperative complications. In a multivariate analysis, CCI of ≥3 (
P
= 0.034), ASA score of 3 (
P
= 0.019), and intraoperative blood loss of ≥50 ml (
P
= 0.016) were found to be independent risk factors of postoperative complications. In contrast, age was not found to significantly affect the risk of postoperative complications.
Conclusions
Laparoscopic gastrectomy for gastric cancer can be successfully performed in elderly patients with an acceptable complication rate. This study suggested that high CCI, ASA score, and intraoperative blood loss volume were identified as independent predictors of postoperative complications after laparoscopic gastrectomy for gastric cancer.</description><subject>Abdominal Surgery</subject><subject>Aftercare</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Dissection</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Laparotomy</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Postoperative Complications - epidemiology</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Survival Rate - trends</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1LxDAQhoMo7rr6A7xIwYuXajJJmvYoi1-w4EXPIUmna5d-mXQP--_N0lVE8DTM5Jl3wkPIJaO3jFJ1FygVmUgpk6nggqbyiMyZ4JACsPyYzGnBaQqqEDNyFsKGRrxg8pTMIGPAOVdzslyZwfg-uH6oXbI2YfToxr7dJVXvpz7Onekc-qTukvEDE2xK9M0uGcxYYzeGc3JSmSbgxaEuyPvjw9vyOV29Pr0s71epkwBjCjkoARXPwCqHzpal5YWjaB2qylprSlkKKhgXBRYO8zh1FctE5jKlMoZ8QW6m3MH3n1sMo27r4LBpTIf9NmimlOQ5sBixINd_0E2_9V383Z4SilOQECk2US4aCB4rPfi6NX6nGdV7w3oyrKNhvTesZdy5OiRvbYvlz8a30gjABIT41K3R_zr9b-oX_zWGIw</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Fujisaki, Muneharu</creator><creator>Shinohara, Toshihiko</creator><creator>Hanyu, Nobuyoshi</creator><creator>Kawano, Susumu</creator><creator>Tanaka, Yujiro</creator><creator>Watanabe, Atsushi</creator><creator>Yanaga, Katsuhiko</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160401</creationdate><title>Laparoscopic gastrectomy for gastric cancer in the elderly patients</title><author>Fujisaki, Muneharu ; Shinohara, Toshihiko ; Hanyu, Nobuyoshi ; Kawano, Susumu ; Tanaka, Yujiro ; Watanabe, Atsushi ; Yanaga, Katsuhiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-282742f362b7cecbddb39c0ebce7fbbbad5d4041349e9ce8e7fcf1646c67761e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; jpn</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Aftercare</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Dissection</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Laparotomy</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Postoperative Complications - epidemiology</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fujisaki, Muneharu</creatorcontrib><creatorcontrib>Shinohara, Toshihiko</creatorcontrib><creatorcontrib>Hanyu, Nobuyoshi</creatorcontrib><creatorcontrib>Kawano, Susumu</creatorcontrib><creatorcontrib>Tanaka, Yujiro</creatorcontrib><creatorcontrib>Watanabe, Atsushi</creatorcontrib><creatorcontrib>Yanaga, Katsuhiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fujisaki, Muneharu</au><au>Shinohara, Toshihiko</au><au>Hanyu, Nobuyoshi</au><au>Kawano, Susumu</au><au>Tanaka, Yujiro</au><au>Watanabe, Atsushi</au><au>Yanaga, Katsuhiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic gastrectomy for gastric cancer in the elderly patients</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>30</volume><issue>4</issue><spage>1380</spage><epage>1387</epage><pages>1380-1387</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
This study aimed to investigate the short-term surgical outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients in order to determine the safety, feasibility, and risk factors for postoperative complications associated with this procedure.
Methods
We retrospectively investigated 208 patients who underwent laparoscopic gastrectomy for gastric cancer between January 2007 and September 2014. After excluding 15 patients with unusual medical histories or surgical treatments, 193 were selected for this cohort study. We divided the patients into two cohorts: elderly patients (≥75 years old) and non-elderly patients (<74 years old). We compared these cohorts with respect to clinicopathological characteristics and intraoperative and postoperative parameters.
Results
The overall complication rates were 11.4 % (8 of 70 patients) in the elderly cohort and 8.1 % (10 of 123 patients) in the non-elderly cohort (
P
= 0.449). In a univariate analysis, Charlson comorbidity index (CCI) of ≥3, American Society of Anesthesiologists (ASA) score of 3, operative time of ≥330 min, and intraoperative blood loss of ≥50 ml were found to correlate significantly with postoperative complications. In a multivariate analysis, CCI of ≥3 (
P
= 0.034), ASA score of 3 (
P
= 0.019), and intraoperative blood loss of ≥50 ml (
P
= 0.016) were found to be independent risk factors of postoperative complications. In contrast, age was not found to significantly affect the risk of postoperative complications.
Conclusions
Laparoscopic gastrectomy for gastric cancer can be successfully performed in elderly patients with an acceptable complication rate. This study suggested that high CCI, ASA score, and intraoperative blood loss volume were identified as independent predictors of postoperative complications after laparoscopic gastrectomy for gastric cancer.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26123337</pmid><doi>10.1007/s00464-015-4340-5</doi><tpages>8</tpages></addata></record> |
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| language | eng ; jpn |
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| subjects | Abdominal Surgery Aftercare Aged Aged, 80 and over Cohort analysis Comorbidity Dissection Female Gastrectomy - methods Gastric cancer Gastroenterology Gastrointestinal surgery Gynecology Hepatology Hospitals Humans Incidence Japan - epidemiology Laparoscopy Laparoscopy - methods Laparotomy Lymphatic system Male Medical personnel Medicine Medicine & Public Health Middle Aged Operative Time Postoperative Complications - epidemiology Proctology Retrospective Studies Risk Factors Stomach Neoplasms - mortality Stomach Neoplasms - surgery Surgery Surgical outcomes Survival Rate - trends |
| title | Laparoscopic gastrectomy for gastric cancer in the elderly patients |
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