[Benefits of Laparoscopic Gastrectomy for Elderly Patients: Masato Mitsuda].

Abstract

Objective: To evaluate the outcomes of laparoscopic gastrectomy for gastric cancer in elderly patients.

Methods: We evaluated the short-term outcomes of open and laparoscopic gastrectomy procedures performed in 89 patients with gastric cancer(≥80 years: n=13, <80 years: n=76)between September 2013 and March 2023.

Results: There were no significant differences in patient background, surgical technique, surgical approach, pathology, or short-term outcomes. Preoperative nutritional status(PNI and GNRI)was significantly lower in the elderly group. Laparoscopic surgery was associated with a longer operative time, lower blood loss, and shorter postoperative hospital stay than open surgery. There was no difference in the rates of CD Grade 3+ complications between open and laparoscopic surgery in patients aged <80 years, while laparoscopic surgery was associated with significantly lower complication rates in patients aged ≥80 years. Considering that patients in the open surgery group were more likely to have advanced cancer, we performed a risk factor analysis for CD Grade 3+ complications in patients >80 years of age, and demonstrated that the surgical approach and operative time were significantly associated with the risk of complications.

Conclusion: The results suggest that laparoscopic surgery may reduce complication rates in elderly patients.