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Does Age Matter in the Indication for Laparoscopy-Assisted Gastrectomy?

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Laparoscopy-assisted gastrectomy (LAG) is being increasingly performed in Japan. However, the indication of LAG in elderly patients who usually have preoperative morbidities and reduced functional capacities still remains unclear.

Materials and Methods

Two hundred eighty-nine patients who underwent LAG at the Cancer Institute Hospital were included in this study. Among them, 240 cases were younger than 75 years old (Y-LAG group), and 49 cases were 75 years old or older (E-LAG group). Early surgical outcomes between the two groups were compared to clarify the feasibility of performing LAG in elderly patients.

Results

The E-LAG group had a higher incidence of preoperative morbidities; however, the frequency of intraoperative and postoperative complications in this group was not significantly different from the Y-LAG group (9% vs 11%). The operation time was significantly shorter, and the number of retrieved lymph nodes was significantly smaller in the E-LAG group compared to the Y-LAG group. However, other early surgical outcomes were not significantly different between two groups.

Conclusions

LAG proved to be a feasible and safe procedure in elderly patients provided that the patients were selected carefully.

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Reference

  1. Tashiro A, Sano M, Kinameri K, Fujita K, Takeuchi Y. Comparing mass screening techniques for gastric cancer in Japan. World J Gastroenterol 2006;12:4873–4874.

    PubMed  Google Scholar 

  2. Kunisaki C, Ishino J, Nakajima S, Motohashi H, Akiyama H, Nomura M, et al. Outcomes of mass screening for gastric carcinoma. Ann Surg Oncol 2006;13:221–228. doi:10.1245/ASO.2006.04.028.

    Article  PubMed  Google Scholar 

  3. Miura S, Kodera Y, Fujiwara M, Ito S, Mochizuki Y, Yamamura Y, et al. Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: a critical reappraisal from the viewpoint of lymph node retrieval. J Am Coll Surg 2004;198:933–938. doi:10.1016/j.jamcollsurg.2004.01.021.

    Article  PubMed  Google Scholar 

  4. Kim MC, Kim KH, Kim HH, Jung GJ. Comparison of laparoscopy-assisted by conventional open distal gastrectomy and extraperigastric lymph node dissection in early gastric cancer. J Surg Oncol 2005;91:90–94. doi:10.1002/jso.20271.

    Article  PubMed  Google Scholar 

  5. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, et al. Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 2005;241:232–237. doi:10.1097/01.sla.0000151892.35922.f2.

    Article  PubMed  Google Scholar 

  6. Hayashi H, Ochiai T, Shimada H, Gunji Y. Prospective randomized study of open versus laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection for early gastric cancer. Surg Endosc 2005;19:1172–1176. doi:10.1007/s00464-004-8207-4.

    Article  PubMed  CAS  Google Scholar 

  7. Noshiro H, Nagai E, Shimizu S, Uchiyama A, Tanaka M. Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer. Surg Endosc 2005;19:1592–1596. doi:10.1007/s00464-005-0175-9.

    Article  PubMed  CAS  Google Scholar 

  8. Mochiki E, Kamiyama Y, Aihara R, Nakabayashi T, Asao T, Kuwano H. Laparoscopic assisted distal gastrectomy for early gastric cancer: Five years’ experience. Surgery 2005;137:317–322. doi:10.1016/j.surg.2004.10.012.

    Article  PubMed  Google Scholar 

  9. Mochiki E, Nakabayashi T, Kamimura H, Haga N, Asao T, Kuwano T. Gastrointestinal recovery and outcome after laparoscopy-assisted versus conventional open distal gastrectomy for early gastric cancer. World J Surg 2002;26:1145–1149. doi:10.1007/s00268-002-6286-8.

    Article  PubMed  Google Scholar 

  10. Adachi Y, Shiraishi N, Shiromizu Bandoh T, Aramaki M, Kitano S. Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg 2000;135:806–810. doi:10.1001/archsurg.135.7.806.

    Article  PubMed  CAS  Google Scholar 

  11. Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, et al. Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 1999;229:49–54. doi:10.1097/00000658-199901000-00006.

    Article  PubMed  CAS  Google Scholar 

  12. Sakuramoto S, Kikuchi S, Kuroyama S, Futawatari N, Katada N, Kobayashi N, et al. Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc 2006;20:55–60. doi:10.1007/s00464-005-0126-5.

    Article  PubMed  CAS  Google Scholar 

  13. Joris JL, Noirot DP, Legrand MJ, Jacquet NJ, Lamy ML. Hemodynamic changes during laparoscopic cholecystectomy. Anesth Analg 1993;76:1067–1071. doi:10.1213/00000539-199305000-00027.

    Article  PubMed  CAS  Google Scholar 

  14. Ballesta Lopez C, Cid JA, Poves I, Bettonica C, Villegas L, Memon MA. Laparoscopic surgery in the elderly patient. Surg Endosc 2003;17:333–337. doi:10.1007/s00464-002-9056-7.

    Article  PubMed  CAS  Google Scholar 

  15. Harris SN, Ballantyne GH, Luther MA, Perrino AC Jr. Alterations of cardiovascular performance during laparoscopic colectomy: a combined hemodynamic and echocardiographic analysis. Anesth Analg 1996;83:482–487. doi:10.1097/00000539-199609000-00007.

    Article  PubMed  CAS  Google Scholar 

  16. Japanese Gastric Cancer A. Japanese Classification of Gastric Carcinoma—2nd English edition. Gastric Cancer 1998;1:10–24.

    Article  Google Scholar 

  17. Nunobe S, Hiki N, Fukunaga T, Tokunaga M, Ohyama S, Seto Y, et al. Laparoscopy-assisted pylorus-preserving gastrectomy: Preservation of vagus nerve and infrapyloric blood flow induces less stasis. World J Surg 2007;31:2335–2340. doi:10.1007/s00268-007-9262-5.

    Article  PubMed  Google Scholar 

  18. Hiki N, Shimoyama S, Yamaguchi H, Kubota K, Kaminishi M. Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg 2006;203:162–169. doi:10.1016/j.jamcollsurg.2006.05.003.

    Article  PubMed  Google Scholar 

  19. Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc 2004;18:182–185. doi:10.1007/s00464-003-8820-7.

    Article  PubMed  CAS  Google Scholar 

  20. Shiraishi N, Yasuda K, Kitano S. Laparoscopic gastrectomy with lymph node dissection for gastric cancer. Gastric Cancer 2006;9:167–176. doi:10.1007/s10120-006-0380-9.

    Article  PubMed  Google Scholar 

  21. Law WL, Chu KW, Tung PH. Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 2002;195:768–773. doi:10.1016/S1072-7515(02)01483-7.

    Article  PubMed  Google Scholar 

  22. Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 2003;138:1083–1088. doi:10.1001/archsurg.138.10.1083.

    Article  PubMed  Google Scholar 

  23. Mochiki E, Ohno T, Kamiyama Y, Aihara R, Nakabayashi T, Asao T, et al. Laparoscopy-assisted gastrectomy for early gastric cancer in young and elderly patients. World J Surg 2005;29:1585–1591. doi:10.1007/s00268-005-0208-5.

    Article  PubMed  Google Scholar 

  24. Yasuda K, Sonoda K, Shiroshita H, Inomata M, Shiraishi N, Kitano S. Laparoscopically assisted distal gastrectomy for early gastric cancer in the elderly. Br J Surg 2004;91:1061–1065. doi:10.1002/bjs.4615.

    Article  PubMed  CAS  Google Scholar 

  25. Bittner R, Butters M, Ulrich M, Uppenbrink S, Beger HG. Total gastrectomy. Updated operative mortality and long-term survival with particular reference to patients older than 70 years of age. Ann Surg 1996;224:37–42. doi:10.1097/00000658-199607000-00006.

    Article  PubMed  CAS  Google Scholar 

  26. Katai H, Sasako M, Sano T, Fukagawa T. Gastric cancer surgery in the elderly without operative mortality. Surg Oncol 2004;13:235–238. doi:10.1016/j.suronc.2004.09.007.

    Article  PubMed  Google Scholar 

  27. Wu CW, Lo SS, Shen KH, Hsieh MC, Lui WY, P’Eng FK. Surgical mortality, survival, and quality of life after resection for gastric cancer in the elderly. World J Surg 2000;24:465–72. doi:10.1007/s002689910074.

    Article  PubMed  CAS  Google Scholar 

  28. Eguchi T, Fujii M, Takayama T. Mortality for gastric cancer in elderly patients. J Surg Oncol 2003;84:132–136. doi:10.1002/jso.10303.

    Article  PubMed  Google Scholar 

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Correspondence to Naoki Hiki.

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Tokunaga, M., Hiki, N., Fukunaga, T. et al. Does Age Matter in the Indication for Laparoscopy-Assisted Gastrectomy?. J Gastrointest Surg 12, 1502–1507 (2008). https://doi.org/10.1007/s11605-008-0567-y

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  • DOI: https://doi.org/10.1007/s11605-008-0567-y

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