Short-term outcomes and prognosis of laparoscopy-assisted total gastrectomy in elderly patients with stomach cancer
BACKGROUND: The aim of this study was to evaluate the short-term outcomes and prognosis of laparoscopy-assisted total gastrectomy (LTG) in elderly patients with gastric cancer.
METHODS: The clinical data of 275 patients aged over 65 years undergoing open total gastrectomy (OTG, n = 184) or laparoscopy-assisted total gastrectomy (LTG, n = 91) were reviewed from January 2015 to August 2017 at the First Affiliated Hospital of the University of Science and Technology of China. Short-term outcomes were compared between the two groups, and risk factors for postoperative complications were explored. In addition, the 2-year overall survival (OS) and disease-free survival (DFS) were investigated for both groups.
RESULTS: Except for the ASA score (P = 0.01), there was no significant difference regarding patient baselines between the two groups. Patients in the LTG group had a longer operative time (P < 0.001), less intraoperative blood loss (P = 0.004), a shorter time of resumption to a semi-liquid diet (P < 0.001) and a shorter postoperative hospital stay (P = 0.001). The incidence of pulmonary complications was significantly lower in the LTG group than in the OTG group (4.4% vs. 13%, P = 0.026). The number of lymph nodes harvested in the LTG group was higher than that in the OTG group (20.7 ± 7.4 vs. 17.5 ± 6.9, P = 0.001), and the proportion of patients with TNM stage III gastric cancer was higher in the LTG group than in the OTG group (P = 0.035). There was no significant difference in the 2-year OS rate or 2-year DFS rate between the two groups (P = 0.057 and P = 0.344). Sex, age, preoperative comorbidity, intraoperative blood loss, and TNM stage were identified as independent prognostic factors for postoperative survival.
CONCLUSION: Comparing with OTG, LTG is feasible and contributes to less surgical trauma and a faster recovery after total gastrectomy. In addition, LTG contributes to a lower risk of postoperative pulmonary complications. Regarding oncological results, LTG is more effective for lymph node dissection and has a comparable long-term prognosis as OTG.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Surgical endoscopy - 34(2020), 12 vom: 28. Dez., Seite 5428-5438 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Liu, Dongliang [VerfasserIn] |
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| Links: |
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| Themen: |
Elderly patients |
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| Anmerkungen: |
Date Completed 28.05.2021 Date Revised 28.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00464-019-07338-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305898779 |
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| 100 | 1 | |a Liu, Dongliang |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Short-term outcomes and prognosis of laparoscopy-assisted total gastrectomy in elderly patients with stomach cancer |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 28.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The aim of this study was to evaluate the short-term outcomes and prognosis of laparoscopy-assisted total gastrectomy (LTG) in elderly patients with gastric cancer | ||
| 520 | |a METHODS: The clinical data of 275 patients aged over 65 years undergoing open total gastrectomy (OTG, n = 184) or laparoscopy-assisted total gastrectomy (LTG, n = 91) were reviewed from January 2015 to August 2017 at the First Affiliated Hospital of the University of Science and Technology of China. Short-term outcomes were compared between the two groups, and risk factors for postoperative complications were explored. In addition, the 2-year overall survival (OS) and disease-free survival (DFS) were investigated for both groups | ||
| 520 | |a RESULTS: Except for the ASA score (P = 0.01), there was no significant difference regarding patient baselines between the two groups. Patients in the LTG group had a longer operative time (P < 0.001), less intraoperative blood loss (P = 0.004), a shorter time of resumption to a semi-liquid diet (P < 0.001) and a shorter postoperative hospital stay (P = 0.001). The incidence of pulmonary complications was significantly lower in the LTG group than in the OTG group (4.4% vs. 13%, P = 0.026). The number of lymph nodes harvested in the LTG group was higher than that in the OTG group (20.7 ± 7.4 vs. 17.5 ± 6.9, P = 0.001), and the proportion of patients with TNM stage III gastric cancer was higher in the LTG group than in the OTG group (P = 0.035). There was no significant difference in the 2-year OS rate or 2-year DFS rate between the two groups (P = 0.057 and P = 0.344). Sex, age, preoperative comorbidity, intraoperative blood loss, and TNM stage were identified as independent prognostic factors for postoperative survival | ||
| 520 | |a CONCLUSION: Comparing with OTG, LTG is feasible and contributes to less surgical trauma and a faster recovery after total gastrectomy. In addition, LTG contributes to a lower risk of postoperative pulmonary complications. Regarding oncological results, LTG is more effective for lymph node dissection and has a comparable long-term prognosis as OTG | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Elderly patients | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Laparoscopy-assisted surgery | |
| 650 | 4 | |a Open surgery | |
| 650 | 4 | |a Total gastrectomy | |
| 700 | 1 | |a Liang, Lichuan |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Liu |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Zhiqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Shaojun |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Lei |e verfasserin |4 aut | |
| 700 | 1 | |a He, Yiren |e verfasserin |4 aut | |
| 700 | 1 | |a Fang, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Wan, Xiao |e verfasserin |4 aut | |
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