Laparoscopy-Assisted Gastrectomy in Patients Older Than 80

Yamada, Hiroyuki; Kojima, Kazuyuki; Inokuchi, Mikito; Kawano, Tatsuyuki; Sugihara, Kenichi

doi:10.1016/j.jss.2009.01.032

Cited by 28 publications

(24 citation statements)

References 31 publications

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“…Yamada et al [12] revealed that LAG could be safely performed in patients who were older than 80 years with complication rates and operational outcomes that were similar to those seen for patients aged 70-79 years. We performed only one LAG in the current series.…”

Section: Discussionmentioning

confidence: 87%

Treatment for gastric carcinoma in the oldest old patients

et al. 2011

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Background The strategy for treating extremely aged patients with gastric carcinoma is controversial. This study reviews the prognoses of patients aged 85 years and older who were diagnosed with gastric carcinoma. Methods One hundred seventeen patients aged 85 years and older were diagnosed as having gastric carcinoma after 1969 in our institution. After excluding those at stage IV, 36 cases underwent curative resection and 30 cases received best supportive care (BSC), which we reviewed retrospectively. Results Surgical methods included distal gastrectomy for 28 cases, total gastrectomy for five cases, and other procedures for three cases. Postoperatively, pneumonia developed in four cases, anastomotic leakage in two cases, and pancreatic fistula in one case. Two patients died of pneumonia within 1 month of surgery. Univariate analysis demonstrated that age, surgery, performance status, and sodium level were statistically significant prognostic factors. Multivariate analysis demonstrated that surgery was the only independent prognostic factor. When patients with a performance status of 4 were excluded, the clinical characteristics of the surgery group (n = 36) and BSC group (n = 20) were statistically identical, and the overall survival was significantly better in the surgery group (p = 0.0078).Conclusions Postoperative outcomes were relatively acceptable. Surgery may be feasible and beneficial even for extremely aged patients 85 years and older, except for those with a performance status of 4.

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Section: Discussionmentioning

confidence: 87%

Treatment for gastric carcinoma in the oldest old patients

et al. 2011

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“…Pulmonary comorbidity was related to most types of immediate postoperative complications compared with other comorbidities. As shown by Yamada et al [1], the very elderly group had significantly more frequent cardiovascular disease, and they had significantly poorer lung function, compared with the elderly group. Yet, the overall complication rate and patients' recovery were similar between the two groups.…”

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confidence: 84%

“…The article authored by Yamada et al [1] has provided valuable information on the applicability of laparoscopy-assisted gastrectomy (LAG) for early gastric cancer in elderly patients older than 80. Owing to the aging tendency of patients with early gastric cancer, the authors have focused the analysis of perioperative outcome of LAG on the two groups of elderly patients, namely, elderly group (aged 70 to 79) and very elderly group (age older than 80).…”

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confidence: 99%

“…The benefits of LAG in octogenarians that Yamada et al [1] have focused on are particularly interesting. Elderly patients commonly carry multiple comorbidities, including hypertension, heart disease, pulmonary disease, diabetes mellitus, liver disease, renal disease, and cerebrovascular disease.…”

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confidence: 99%

“…Another aspect that Yamada et al [1] have not described is the oncologic outcome of LAG for octogenarians. One reason that laparoscopic surgery for upper gastrointestinal cancers has not been widely accepted is the concerns of port site metastasis and the adequacy of oncologic clearance.…”

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confidence: 99%

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