Inokuchi Mikito, Tanioka Toshiro, Nakagawa Masatoshi, Okuno Keisuke, Gokita Kentaro, Kojima Kazuyuki
a Department of Gastrointestinal Surgery , Tokyo Medical and Dental University , Bunkyo , Tokyo , Japan.
b Department of Minimally Invasive Surgery , Tokyo Medical and Dental University , Bunkyo , Tokyo , Japan.
J Invest Surg. 2018 Dec;31(6):539-545. doi: 10.1080/08941939.2017.1355025. Epub 2017 Aug 22.
Laparoscopic gastrectomy was shown to be feasible even in elderly patients in many retrospective case-controlled studies. However, the definition of elderly differed among those studies, such as an age of 65, 70, or 75 years or older. This study was conducted to elucidate the advantages of laparoscopic distal gastrectomy (LDG) in very elderly (≥80 years) patients, and comprised 70 patients, 45 of whom underwent LDG and 25 underwent open distal gastrectomy (ODG) between 2004 and September 2016. LDG had significantly less estimated blood loss (p < .01), earlier flatus (p < .01), earlier food intake (p < .01), and shorter hospitalization (p < .01) as compared with ODG. No significant difference between LDG and ODG was found in the incidence of postoperative surgical complications (p = .40), although LDG tended to reduce overall and medical postoperative complications (p = .11 and .09, respectively). LDG might be a feasible, beneficial treatment with good short-term outcomes in very elderly patients with gastric cancer.
在许多回顾性病例对照研究中，腹腔镜胃切除术已被证明即使在老年患者中也是可行的。然而，这些研究中对老年的定义有所不同，例如年龄为65岁、70岁或75岁及以上。本研究旨在阐明腹腔镜远端胃切除术（LDG）在高龄（≥80岁）患者中的优势，该研究纳入了70例患者，其中45例行LDG，25例行开放远端胃切除术（ODG），研究时间为2004年至2016年9月。与ODG相比，LDG的估计失血量显著更少（p <.01），排气更早（p <.01），进食更早（p <.01），住院时间更短（p <.01）。虽然LDG倾向于降低总体和医疗术后并发症的发生率（分别为p =.11和.09），但LDG和ODG在术后手术并发症发生率方面未发现显著差异（p =.40）。对于高龄胃癌患者，LDG可能是一种可行的、有益的治疗方法，具有良好的短期疗效。
