Analysiis for the safety and feasibility of total laparoscopic radical gastrectomy in treatment of gastric cancer in theelderly

doi:10.3969/j.issn.1002-7386.2018.11.017

Abstract：Objective To investigate the safety and feasibility of total laparoscopic radical gastrectomy of gastric cancer in elderly patients. Methods The clinical data about 72 elderly patients ( age≥70 years) with gastric cancer who underwent gastrectomy in our hospital from March 2011 to October 2017 were retrospectively analyzed,in whom, 34 patients in group A were treated by laparoscopic surgery and 38 patients in group B were treated by open surgery. The preoperative scores of American Society of Anesthesiologists ( ASA) , postoperative stage of Tumor Node Metastasis ( TNM) , operation time, the intraoperative bleeding volume, cardiopulmonary function before and after surgery, intraoperative airway pressure, the recovery time of gastrointestinal function after operation, postoperative complications and lymph node positive rate of samples were observed and compared between two groups. Results There were no significantly differences in preoperative ASA scores, postoperative TNM stages and operation time between two groups (P>0. 05). The intraoperative cardiac functions including cardiac index and ejection fraction, pulmonary functions including arterial blood PaCO2 and pH values in group A were significantly increased,as compared with those in group B (P <0. 05). However there was no significant differences in cardiopulmonary function at 24 hours after operation between two groups (P>0. 05). The intraoperative airway pressure in group A was significantly higher than that in group B (P<0. 05). The exhaust time and hospitalization time after operation in group A were significantly shorter than those in group B (P<0. 05). The intraoperative bleeding volume and incidence rate of postoperative complications in group A were significantly lower than those in group B (P<0. 05). There were no significantly differences in the numbers of pathologic lymph nodes and lymph node positive rate between the two groups (P >0. 05). Moreover there was no significant difference in total survival rate after 15-month follow-up between group A and group B (56. 1％ vs 57. 9％,P>0. 05). Conclusion The laparoscopic radical gastrectomy of gastric cancer in elderly patients has advantages of less intraoperative bleeding volume and postoperation quick recovery of gastrointestinal function, with better safety and feasibility.