Esser G, Zielstra S
Langenbecks Arch Chir. 1982;357(2):85-91. doi: 10.1007/BF01237454.
Out of 422 patients operated on for gastric carcinoma from 1970-1980, 152 were older than 70 years. We performed a total resection of the stomach on 145 patients: 63 were 60-69 years old, with a 14% mortality; 36 were 70-79 years old, with a 25% mortality. In curative gastrectomies, the mortality was 8% in patients in their seventies (4 cases out of 48) and 12% in their eighties (3 cases of 25). In additional resection of neighbouring organs (liver, colon, and pancreas) mortality was only increased to 17% in the seventh decade and 20% in the eighth. Therefore, radical surgery for carcinoma of the stomach in form of a gastrectomy is justified even in older people, as there is a curative chance. In palliative gastrectomies the mortality has been too high: 33% (5 out of 15) in the seventh decade and 58% (7 out of 12) over the seventh decade. Palliative gastrectomies are only justified in older people if there are special indications.
在1970年至1980年接受胃癌手术的422例患者中,152例年龄超过70岁。我们对145例患者实施了胃全切术:63例年龄在60至69岁之间,死亡率为14%;36例年龄在70至79岁之间,死亡率为25%。在根治性胃切除术中,七十多岁患者的死亡率为8%(48例中有4例),八十多岁患者的死亡率为12%(25例中有3例)。在附加切除邻近器官(肝脏、结肠和胰腺)时,七十年代死亡率仅增至17%,八十年代增至20%。因此,即使是老年人,以胃切除术形式进行的胃癌根治性手术也是合理的,因为存在治愈的机会。在姑息性胃切除术中,死亡率过高:七十年代为33%(15例中有5例),七十年代以上为58%(12例中有7例)。仅在有特殊指征时,老年人才适合进行姑息性胃切除术。