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Laparoscopic gastrectomy for gastric cancer: early experience among the elderly

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Abstract

Background

The data are scarce on the outcome for elderly patients presenting with resectable gastric cancer in the West who have been treated with minimally invasive surgery. This report presents the authors’ early experience with totally laparoscopic gastric resections for cancer in elderly patients.

Methods

A total of 20 patients underwent laparoscopic gastrectomy procedures: 14 distal, 5 subtotal, and 1 total gastrectomy. The male-to-female ratio was 15 to 5. The ages ranged from 75 to 88 years (mean, 80 years).

Results

All cases were managed laparoscopically with R0 resection. Four patients needed high-dependency unit care postoperatively. There were no perioperative deaths. The median time required for the procedure was 212 min, and time to diet was 4 days. The hospital stay was 8 days. Four patients experienced significant complications, with two patients requiring reoperation. The pathology was adenocarcinoma for 17 patients and high-grade dysplasia for 3 patients. Conclusion: Among elderly patients for whom conventional gastric surgery carries a high morbidity and mortality risk, minimal access surgery may offer equivalent oncologic integrity but with superior safety and economy. The primary aim is to remove the tumor with at least a D1 lymphadenectomy.

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Acknowledgments

The authors express their thanks and gratitude to the Department of Surgery at Worthing Hospital, to its staff in theater 5 (John Barclay, Frank Chan, Chris Ellsey), and to the extended upper gastrointestinal team. They also thank the theater staff at St Georges Hospital, London, John Radcliffe Hospital, and Oxford and Aintree University Hospitals, Liverpool. Finally we would like to thank Colette Blunden who was responsible for the illustrations.

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Authors and Affiliations

  1. Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, BN11 2HR, UK

    K. K. Singh & Iryna Rybinkina

  2. Royal Marsden Hospital, Fulham Road, London, UK

    A. Rohatgi & Satvinder Mudan

  3. John Radcliffe Hospital, Headly Way, Headington, Oxford, UK

    Peter McCulloch

Authors
  1. K. K. Singh
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  2. A. Rohatgi
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  3. Iryna Rybinkina
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  4. Peter McCulloch
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  5. Satvinder Mudan
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Correspondence to K. K. Singh.

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Singh, K.K., Rohatgi, A., Rybinkina, I. et al. Laparoscopic gastrectomy for gastric cancer: early experience among the elderly. Surg Endosc 22, 1002–1007 (2008). https://doi.org/10.1007/s00464-007-9561-9

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  • DOI: https://doi.org/10.1007/s00464-007-9561-9

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