TITLE:
Laparoscopic Gastrectomy after the Age of Eighty: Still a Good Choice?
AUTHORS:
José Barbosa, Silvestre Carneiro, John Preto, Hugo Sousa, André Pinho, Costa Maia
KEYWORDS:
Gastrectomy; Elderly; Laparoscopic; Minimally; Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.4 No.9A,
October
21,
2013
ABSTRACT: Main Goals: Evaluation and
comparison of short-term results of totally laparoscopic gastrectomy performed
for gastric carcinoma in two groups of patients: older and younger than eighty
years. Material and Methods: From
1st January 2011 to 31st October 2012, we have treated 110 patients for gastric
carcinoma. 79 patients were submitted to radical gastric resection (the
remainder 31 patients either presented with cardia carcinoma or were submitted
to palliative treatment). In 33 cases we performed a laparoscopic gastrectomy
while in the remainder 46 cases, the open
approach was used. The 33 patients operated by a laparoscopic approach were the
subject of this study. They were divided in two groups: Group A—patients eighty
years old or older (10 cases) and Group B—patients younger than 80 years (23 cases). We evaluated and compared the short-term
outcomes of both groups. Results: In
all 33 cases, a gastrectomy was performed using a totally
laparoscopic approach. There was no need to convert into open surgery. No patient
needed to stay in the Intensive Care Unit. One patient needed a night stay in
the Post Anesthetic Care Unit, due to subcutaneous emphysema (which resolved
within 24 hours). There was a fatality in Group B, due to hepatic failure. The
median of the operating time was 224 minutes in Group B and 199 minutes in Group
A. The difference was non-significant (pvalue > 0.05). Group A patients were discharged in 6 to 10 days while those in Group
B were discharged in 6 to 9 days. Conclusion: The results in this series suggest that totally laparoscopic gastrectomy is
effective and safe in patients eighty years old and older, with low morbidity
and mortality and short hospital stay. It compares favourably with the results
of the same technique applied to younger patients. We suggest that laparoscopic
approach to gastrectomy can be used in older patients, allowing them to benefit from the advantages of
minimally invasive surgery.