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Laparoscopic distal gastrectomy in old-old patients: the first Western experience

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Abstract

Background

This is the first Western study presenting short-term results on patients older than 80 years affected by gastric cancer and treated with laparoscopic distal gastrectomy.

Methods

A multicentre prospective database on patients suffering from distal gastric cancer with age of ≥ 80 undergone to distal gastrectomy was analysed retrospectively. End points were length of hospital stay (LoS) after surgery, and times to stool passage and solid diet initiation, as well as postoperative complications. Univariate analysis of the differences between “laparoscopic” and “open” groups was performed with non-parametric tests.

Results

Forty-six patients (median age: 83 years, median CCI: 5) undergone to distal gastrectomy were analysed. Seventeen out 46 patients (36.9%) underwent laparoscopic distal gastrectomy and extended lymphadenectomy was achieved in 25 cases (25/46, 54.3%). Median number of removed and examined nodes was higher in laparoscopic than in open group. Median LoS was significantly lower in the laparoscopic group (8 vs. 11 days). Complications occurred in 12 patients (26.1%): no significant differences between the two groups. There was a significant difference between the two surgical approaches in term of times for stool passage.

Conclusions

Laparoscopic approach seems to reduce the effect of the surgical trauma without compromising lymphadenectomy also in octogenarian patients with distal gastric cancer.

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Funding

No funding source to declare.

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Authors and Affiliations

  1. Department of Surgery, ASST Valle Olona, Via Pastori 4, 21013, Gallarate, VA, Italy

    Stefano Rausei, Federica Galli & Angelo Benevento

  2. Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

    Marco Milone & Giovanni De Palma

  3. Department of Surgery, University of Ioannina, Ioannina, Greece

    Georgios Lianos

  4. Department of Human Pathology, University of Messina, Messina, Italy

    Gianlorenzo Dionigi

  5. Department of Surgery, Maggiore Hospital, “Ca’ Granda” Policlinico Hospital, University of Milan, Milan, Italy

    Luigi Boni & Elisa Cassinotti

Authors
  1. Stefano Rausei
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  2. Federica Galli
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  3. Marco Milone
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  4. Georgios Lianos
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  5. Gianlorenzo Dionigi
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  6. Giovanni De Palma
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  7. Angelo Benevento
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  8. Luigi Boni
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  9. Elisa Cassinotti
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Contributions

RS: Design and writing. GF: Data collection and statistical analysis. MM: Data collection. Lianos Georgios: Writing. DG: Final revision. DPG: Final revision. BA: Final revision. BL: Writing. CE: Data collection and statistical analysis.

Corresponding author

Correspondence to Stefano Rausei.

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Ethical statement

This study was conducted in accordance with ethical principles for human studies and approved by the local ethics committee. All patients signed a written informed consent specific for gastrectomy with lymphadenectomy and for observational studies related to treatment.

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Rausei, S., Galli, F., Milone, M. et al. Laparoscopic distal gastrectomy in old-old patients: the first Western experience. Updates Surg 73, 1343–1348 (2021). https://doi.org/10.1007/s13304-021-01063-x

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  • DOI: https://doi.org/10.1007/s13304-021-01063-x

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