腹腔镜辅助胃癌根治术对老年胃癌患者的影响。

Effects of laparoscopic-assisted gastrectomy on elderly patients with gastric cancer.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital and Institute, Beijing, China.

出版信息

J BUON. 2021 Mar-Apr;26(2):490-498.

PMID:34076997

Abstract

PURPOSE

Although the acceptance of laparoscopy-assisted gastrectomy (LAG) for the treatment of gastric cancer (GC) has been increasing, it is still controversial that LAG is an applicable treatment method for elderly patients since elderly patients are usually complicated with other diseases. Therefore, this study aimed to investigate the prognostic differences between elderly patients and non-elderly patients after receiving LAG.

METHODS

Patients (n = 306) who received LAG for the treatment of GC from April 2009 to December 2014 were included in the study. The patients were divided into the elderly group (≥ 65 years old, n = 120) and the non-elderly group (< 65 years old, n=186). The postoperative outcomes as well as the morbidity and the survival rates were compared between the two groups.

RESULTS

American Society of Anesthesiologists (ASA) score and comprehensive complication index (CCI) score in the elderly group were significantly higher than those in the non-elderly group (p<0.05). In terms of surgical outcomes, there was no significant difference in blood loss or postoperative hospital stay between the elderly group and the non-elderly group. As for postoperative comorbidities, there were significant differences in intraperitoneal hemorrhage and pleural effusion between the elderly group and the non-elderly group. Moreover, the median follow-up time was 38.5 months, and the overall survival of elderly patients with comorbidities was significantly lower than that of the elderly patients without comorbidities (p<0.05).

CONCLUSIONS

LAG can be performed safely and successfully in the elderly population with acceptable postoperative and long-term results.

摘要

目的

尽管腹腔镜辅助胃癌（GC）手术（LAG）的接受程度不断提高，但对于老年患者，LAG 是否是一种适用的治疗方法仍存在争议，因为老年患者通常伴有其他疾病。因此，本研究旨在探讨接受 LAG 治疗后老年患者与非老年患者的预后差异。

方法

本研究纳入了 2009 年 4 月至 2014 年 12 月期间接受 LAG 治疗 GC 的患者（n=306）。将患者分为老年组（≥65 岁，n=120）和非老年组（<65 岁，n=186）。比较两组患者的术后结局、发病率和生存率。

结果

老年组的美国麻醉医师协会（ASA）评分和综合并发症指数（CCI）评分显著高于非老年组（p<0.05）。在手术结果方面，老年组与非老年组在出血量或术后住院时间方面无显著差异。在术后并发症方面，老年组与非老年组在腹腔内出血和胸腔积液方面存在显著差异。此外，中位随访时间为 38.5 个月，合并症老年患者的总体生存率明显低于无合并症老年患者（p<0.05）。