ARE THERE DIFFERENCES IN LAPAROSCOPIC GASTRECTOMY MORBIDITY AND MORTALITY BETWEEN YOUNG AND OLDER?

ABSTRACT Background: Due to the longer life expectancy and consequently an increase in the elderly population, a higher incidence of gastric cancer is expected in this population in the coming decades. Aim: To compare the results of laparoscopic GC surgical treatment between individuals aged<65 years (group I) and ≥ 65 years (group II), according to clinical, surgical, and histopathological characteristics. Methods: A observational retrospective study was performed by analyzing medical charts of patients with gastric cancer undergoing total or subtotal laparoscopic gastrectomy for curative purposes by a single oncologic surgery team. Results: Thirty-six patients were included in each group. Regarding the ASA classification, 31% of the patients in group I was ASA 1, compared to 3.1% in group II. The mean number of concomitant medications in group II was statistically superior to group I (5±4.21 x 1.42±3.08, p<0.001). Subtotal gastrectomy was the most performed procedure in both groups (69.4% and 63.9% in groups I and II, respectively) due to the high prevalence of distal tumors in both groups, 54.4% group I and 52.9% group II. According to Lauren's classification, group I presented a predominance of diffuse tumors (50%) and group II the intestinal type (61.8%). There was no difference between the two groups regarding the number of resected lymph nodes and lymph node metastases and the days of hospitalization and mortality. Conclusion: Laparoscopic gastrectomy showed to be a safe procedure, without a statistical difference in morbidity, mortality, and hospitalization time between both groups.

摘要
背景：随着人均预期寿命延长，老年人口规模持续扩大，未来数十年内老年人群胃癌（gastric cancer, GC）的发病率预计将进一步升高。
目的：基于临床、手术及组织病理学特征，对比年龄<65岁（组I）与≥65岁（组II）患者接受腹腔镜胃癌手术治疗的临床疗效差异。
方法：本研究为回顾性观察性研究，由单一肿瘤外科团队回顾分析接受根治性全腹腔镜或次全腹腔镜胃切除术的胃癌患者病历资料。
结果：两组各纳入36例患者。在美国麻醉医师协会（ASA）分级中，组I有31%的患者为ASA 1级，而组II仅为3.1%。组II患者合并用药的平均数量显著高于组I（5±4.21 vs 1.42±3.08，p<0.001）。两组中最常用的手术方式均为次全胃切除术（组I与组II占比分别为69.4%、63.9%），这与两组远端胃癌的高患病率相符：组I远端肿瘤占比54.4%，组II为52.9%。根据劳伦分型（Lauren's classification），组I以弥漫型胃癌为主（占比50%），组II则以肠型胃癌为主（占比61.8%）。两组在清扫淋巴结数量、淋巴结转移情况、住院天数及死亡率方面均无统计学差异。
结论：腹腔镜胃切除术是一种安全的手术术式，两组患者在并发症发生率、死亡率及住院时长方面均无统计学差异。