Journal of Gastrointestinal Surgery

, Volume 19, Issue 11, pp 1949–1957 | Cite as

Short- and Long-Term Outcomes After Laparoscopic Versus Open Total Gastrectomy for Elderly Gastric Cancer Patients: a Propensity Score-Matched Analysis

  • Jun Lu
  • Chang-ming Huang
  • Chao-hui Zheng
  • Ping Li
  • Jian-wei Xie
  • Jia-bin Wang
  • Jian-xian Lin
  • Qi-yue Chen
  • Long-long Cao
  • Mi Lin
Original Article



To date, it has been unclear whether laparoscopic-assisted total gastrectomy (LTG) was a suitable treatment for elderly patients (aged 65 years and older) with gastric cancer. The aim of the present study was to clarify the value of LTG in the elderly using a propensity score matching method.


We prospectively collected data from 675 elderly gastric cancer patients who underwent total gastrectomies at our institution between January 2002 and February 2012. Propensity score matching was applied at a ratio of 1:1 to compare the LTG and open total gastrectomy (OTG) groups. The operation results, hospital courses, and survival rates were compared between the matched groups.


The LTG group had a significantly shorter mean operating time (194 vs. 267 min, P < 0.001) and significantly less intraoperative blood loss (92 vs. 204 ml, P < 0.001). The total number of collected lymph nodes was similar in the two groups. Postoperatively, the length of hospital stay was shorter in the LTG group than in the OTG group (median 14.4 vs. 16.6 days; P = 0.001); however, no significant intergroup differences were found in morbidity or mortality. Furthermore, the 3-year overall survival (OS) rate was similar between the two groups (P = 0.517).


LTG for elderly gastric cancer is feasible and safe with acceptable oncologic outcomes. Therefore, patient age alone should not be considered a contraindication in the decision between LTG and OTG treatment options. A high-volume prospective study is needed to confirm this rationale.


Gastric cancer Elderly patients Laparoscopic total gastrectomy Propensity-matched study Survival 



The authors thank the medical staff who contributed to the success of this patient management.

Conflict of Interest

The authors declare that they have no competing interests.

Financial Support

This work was supported by the National Key Clinical Specialty Discipline Construction Program of China (No. [2012]649) and Key Projects of Science and Technology Plan of Fujian Province (No. 2014Y0025).


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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Jun Lu
    • 1
  • Chang-ming Huang
    • 1
  • Chao-hui Zheng
    • 1
  • Ping Li
    • 1
  • Jian-wei Xie
    • 1
  • Jia-bin Wang
    • 1
  • Jian-xian Lin
    • 1
  • Qi-yue Chen
    • 1
  • Long-long Cao
    • 1
  • Mi Lin
    • 1
  1. 1.Department of Gastric SurgeryFujian Medical University Union HospitalFuzhouChina

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