老年胃癌患者的微创手术与开放胃切除术：倾向评分匹配分析
Minimally invasive surgery versus open gastrectomy for older patients with gastric cancer: A propensity score-matching analysis.
作者信息
Yamamoto Masaaki, Omori Takeshi, Masuike Yasunori, Shinno Naoki, Hara Hisashi, Sugase Takahito, Kanemura Takashi, Takeno Atsushi, Hirao Motohiro, Miyata Hiroshi
机构信息
Department of Gastroenterological Surgery Osaka International Cancer Institute 3-1-69 Otemae, Chuo-ku Osaka 5418567 Osaka Japan.
Department of Surgery NHO Osaka National Hospital 2-1-14 Hoenzaka, Chuo-ku Osaka 5400006 Osaka Japan.
出版信息
Ann Gastroenterol Surg. 2024 Jul 15;9(1):69-78. doi: 10.1002/ags3.12842. eCollection 2025 Jan.
AIM
To compare minimally invasive and open surgery for older patients with gastric cancer.
METHODS
This study included 464 consecutive patients with gastric cancer aged ≥75 years who underwent open or laparoscopic gastrectomy at our institution from January 2004 to December 2018. We performed propensity score-matching and compared short- and long-term outcomes between the two groups.
RESULTS
After matching, 332 patients were included in the study (166 in each group). The laparoscopy group had a longer operative time, lesser blood loss, and shorter hospital stays than the open surgery group (all < 0.020). The laparoscopy group had a lower complication rate than the open surgery group ( = 0.002). No significant differences were noted in the 3-y overall, recurrence-free, and disease-free survival between the groups (all > 0.200).
CONCLUSION
Minimally invasive surgery for older patients with gastric cancer may be more beneficial than open gastrectomy in terms of blood loss and hospital stay.
目的
比较老年胃癌患者的微创手术与开放手术。
方法
本研究纳入了2004年1月至2018年12月期间在我院接受开放或腹腔镜胃切除术的464例年龄≥75岁的连续胃癌患者。我们进行了倾向评分匹配，并比较了两组的短期和长期结果。
结果
匹配后，332例患者纳入研究（每组166例）。腹腔镜组手术时间长于开放手术组，失血量少，住院时间短（均<0.020）。腹腔镜组并发症发生率低于开放手术组（=0.002）。两组间3年总生存率、无复发生存率和无病生存率无显著差异（均>0.200）。
结论
老年胃癌患者的微创手术在失血量和住院时间方面可能比开放胃切除术更有益。
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