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老年胃癌患者腹腔镜胃切除术的短期和长期结果

Short- and long-term outcomes of laparoscopic gastrectomy in elderly patients with gastric cancer.

作者信息

Mohri Yasuhiko, Yasuda Hiromi, Ohi Masaki, Tanaka Koji, Saigusa Susumu, Okigami Masato, Shimura Tadanobu, Kobayashi Minako, Kusunoki Masato

机构信息

Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,

出版信息

Surg Endosc. 2015 Jun;29(6):1627-35. doi: 10.1007/s00464-014-3856-4. Epub 2014 Oct 3.

Abstract

BACKGROUND

Elderly patients are regarded as being at increased risk during major abdominal surgery because of a lack of functional reserve and an increased number of comorbidities. The aim of this study was to compare short- and long-term outcomes of laparoscopic gastrectomy between elderly and young gastric cancer patients.

METHODS

Two-hundred ten patients who underwent laparoscopic gastrectomy for gastric cancer at our institution between January 2001 and December 2011 were included in this retrospective study. Patients were divided into two age groups (younger than 70 years and older than 70 years) and were evaluated with respect to postoperative morbidity, quality of life (QOL), and survival.

RESULTS

Postoperative morbidity was similar in elderly and young groups (18.3 vs. 21.6 %; P = 0.718). Overall survival of the elderly group was significantly worse than that of the young group (P < 0.001). However, disease-specific survival was not significantly different between the two groups. Longitudinal postoperative change in QOL in the elderly group showed a recovery similar to that in the young group.

CONCLUSIONS

Laparoscopic gastrectomy can be performed as safely in elderly patients as in young patients, with comparable postoperative results and long-term outcomes, including QOL, although the life expectancy of elderly patients is shorter.

摘要

背景

由于功能储备不足和合并症数量增加,老年患者在接受腹部大手术时被认为风险更高。本研究的目的是比较老年和年轻胃癌患者腹腔镜胃切除术的短期和长期结果。

方法

本回顾性研究纳入了2001年1月至2011年12月期间在我院接受腹腔镜胃癌切除术的210例患者。患者分为两个年龄组(70岁以下和70岁以上),并对术后发病率、生活质量(QOL)和生存率进行评估。

结果

老年组和年轻组的术后发病率相似(18.3%对21.6%;P = 0.718)。老年组的总生存率明显低于年轻组(P < 0.001)。然而,两组的疾病特异性生存率没有显著差异。老年组术后QOL的纵向变化显示出与年轻组相似的恢复情况。

结论

腹腔镜胃切除术在老年患者中可以像在年轻患者中一样安全地进行,术后结果和长期结局(包括QOL)相当,尽管老年患者的预期寿命较短。

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