To determine whether Laparoscopy-Assisted Distal Gastrectomy (LADG) is suitable for treatment of gastric cancer in elderly patients, we conducted a retrospective study to examine the safety and outcomes of LADG performed in elderly patients at our hospital. Patients and Methods: Included in the study were 68 patients (15 aged ≥75 years and 53 aged <75 years) who underwent LADG at our hospital. We compared patients' characteristics (age, sex, and body mass index [BMI]), physical status as defined by the American Society of Anesthesiologists (ASA-PS), medical history, whether endoscopic submucosal dissection (ESD) had been performed previously; surgical factors (operation time, blood loss volume, length of hospital stay, extent of dissection, number of lymph nodes dissected, anastomosis method, time to first flatus, time to first stool, complications); and pathologic factors (tumor location, tumor presence, invasion depth, lymph node metastasis). Results: Mean age of the elderly patients was 79.8 years (75-86 years). Mean BMI was 18.4 (14.3-22.2) kg/m 2 . Three elderly patients were classified into ASA-PS 3, and hypertension was common in the elderly group. The mean duration of surgery was 193.2 (125-290) minutes, and the mean blood loss volume was 52 (4-263) mL. Mean time to first flatus and first stool were 3.0 (2-5) days and 5.3 (4-8) days, respectively. The mean hospital stay was 18.4 (8-48) days. Complications included 1 pancreatic fistula and 1 stenosis associated with an anastomotic ulcer. The mean number of lymph nodes dissected was 33.1 (15-61), and there were 3 cases of lymph node metastasis. Only BMI and the incidence of previous ESD differed between the elderly patients and younger patients. Conclusion:We conclude on the basis of our study findings that laparoscopy-assisted distal gastrectomy can be perfomed safely in patients aged 75 years and older (just as it is in patients under 75 years of age), as long as patient selection is properly carried out.

We conducted a retrospective, single-center study to test our notion that laparoscopic transabdominal preperitoneal (TAPP) mesh repair of inguinal hernia is not inferior to open repair via anterior approach. Patient characteristics and short-term treatment outcomes were compared between 142 patients with 153 defects treated by TAPP repair between January 2010 and December 2015 and 100 patients with 104 defects treated by open anterior repair between September 2008 and December 2015. Patients in the TAPP group were significantly younger than patients in the open repair group. Operation time was significantly longer in the TAPP group at 102.8 minutes, but the blood loss volume did not differ significantly between the 2 groups. Conversion from TAPP repair to open repair was necessary for 6 patients, and this was because of adhesions found intraoperatively in all 6. Significantly fewer postoperative analgesics were used by patients in the TAPP group. Hydrocele occurred as a postoperative complication in both groups, and postoperative recurrence was observed in 2 patients in the TAPP group, but the complication rate did not differ significantly between the 2 groups. Although the TAPP procedure lengthened the repair time, the absence of a significant difference in postoperative complications confirms that TAPP repair compares favorably with open anterior repair.