Laparoscopy-assisted gastrectomy in the elderly: experience from a UK centre



Tandon, A, Rajendran, I, Aziz, M, Kolamunnage-Dona, R ORCID: 0000-0003-3886-6208, Nunes, QM ORCID: 0000-0002-7513-8595 and Shrotri, M
(2017) Laparoscopy-assisted gastrectomy in the elderly: experience from a UK centre. Annals of the Royal College of Surgeons of England, 99 (4). 325 - 331.

[img] Text
Lap Gastrectomy Annals RCS 2016.pdf - OA Published Version

Download (491kB)

Abstract

BACKGROUND Gastric cancer has a high incidence in the elderly in the UK, with a significant number of patients aged 75 years or more. While surgery forms the mainstay of treatment, evidence pertaining to the management of gastric cancer in the Western population in this age group is scarce. METHODS We retrospectively reviewed the outcomes of laparoscopy-assisted total and distal gastrectomies at our centre from 2005 to 2015. Patients aged 70 years or above were included in the elderly group. RESULTS A total of 60 patients underwent laparoscopy-assisted gastrectomy over a 10-year period, with a predominance of male patients. There was no significant difference in the rate of overall surgical and non-surgical complications, in-hospital mortality, operation time and length of hospital stay, between the elderly and non-elderly groups. Univariate analysis, performed for risk factors relating to anastomotic leak and surgical complications, showed that age over 70 years and higher American Association of Anesthesiologists grades are associated with a higher, though not statistically significant, number of anastomotic leaks (P = 1.000 and P = 0.442, respectively) and surgical complications (P = 0.469 and P = 0.162, respectively). The recurrence rate within the first 3 years of surgery was significantly higher in the non-elderly group compared with the elderly group (Log Rank test, P = 0.002). There was no significant difference in survival between the two groups (Log Rank test, P = 0.619). CONCLUSIONS Laparoscopy-assisted gastrectomy is safe and feasible in an elderly population. There is a need for well-designed, prospective, randomised studies with quality of life data to inform our practice in future.

Item Type: Article
Uncontrolled Keywords: Laparoscopy-Assisted Gastrectomy, Elderly, Gastric Carcinoma
Depositing User: Symplectic Admin
Date Deposited: 08 Mar 2017 08:19
Last Modified: 15 Apr 2021 07:20
DOI: 10.1308/rcsann.2016.0344
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3006250