Bittner R, Beger H G, Kraas E, Gögler H
Langenbecks Arch Chir. 1978 Apr 7;344(4):293-307. doi: 10.1007/BF01261267.
In this study it is reported about operative mortality and long-term results of surgery of gastric carcinoma in patients over the age of 70 years. The operative mortality in 50 patients with a distal partial gastrectomy was 16%, the mortality in 24 patients with total gastrectomy was 33.3% and in 14 patients with a proximal gastrectomy the mortality was 28%. The main cause of death (40%) was a pneumonia. There was no correlation between frequency of pneumonia and preoperative results of measurement of lung function. Only advanced arteriosclerotic disease in the heart and brain has a fatal influence on mortality rate. In the old patients the long-term results are determined by the staging of the tumor at the time of operation, too. In the 60 patients, who had left the hospital and who are in our control, the half year survival rate was 78.3%, the 1-year survival rate was 58.3% and the 2-years survival rate is exceeding 41.6%. 14 patients of the 17, who are still alive and who are after 2 1/2 years again explored, are in a very good condition. In comparison with the literature it is to conclude that for the indication to surgery of gastric carcinoma there is important not only the real age of the patient but rather the biological and mental condition of the patient.
本研究报告了70岁以上胃癌患者的手术死亡率及手术长期结果。50例行远端胃部分切除术患者的手术死亡率为16%，24例行全胃切除术患者的死亡率为33.3%，14例行近端胃切除术患者的死亡率为28%。主要死亡原因（40%）为肺炎。肺炎发生率与术前肺功能测量结果之间无相关性。仅心脏和脑部的晚期动脉硬化疾病对死亡率有致命影响。在老年患者中，长期结果也取决于手术时肿瘤的分期。在60例已出院并接受我们随访的患者中，半年生存率为78.3%，1年生存率为58.3%，2年生存率超过41.6%。在17例术后2年半仍存活且再次接受检查的患者中，14例状况良好。与文献相比，可以得出结论，对于胃癌手术适应证而言，重要的不仅是患者的实际年龄，更重要的是患者的生物学和精神状况。
