目的    探讨老年胃癌病人行腹腔镜胃癌根治术的安全性及近期疗效。方法    中国医科大学附属盛京医院胃肠、营养外科自2010年1月至2012年6月对344例老年（年龄≥60岁）胃癌病人行根治性手术，对比分析腹腔镜与开腹术中和术后情况、术后并发症及近期生存差异。并对术后并发症的影响因素进行单、多因素分析。
结果    行腹腔镜手术102例（腔镜组），开腹手术242例（开腹组）。腔镜组与开腹组的手术时间和淋巴结清扫个数差异无统计学意义（P>0.05）；腔镜组术中出血量、术后主动使用止痛泵次数、切口长度、肛门排气时间及术后住院时间均少于或短于开腹组，差异有统计学意义（P<0.05）。腔镜组与开腹组术后并发症发生率分别为16.7%（17/102）和26.9%（65/242），差异有统计学意义（χ2=4.106，P=0.043）。术前合并症、手术时间和是否行腔镜手术是影响老年胃癌病人术后并发症的独立危险因素。313例（91.0%）病人获得6～36个月随访，中位随访时间为19个月，两组的生存曲线差异无统计学意义（P>0.05）。结论    腹腔镜辅助胃癌根治术应用于老年胃癌病人是安全可行的，具有微创优势，有利于减少术后并发症的发生。

Comparative analysis of postoperative complications between laparoscopic and open radical gastrectomy for elderly with gastric cancer        SHAO Hua，SUN Wei，WANG Qiang. Department of Gastrointestinal and Nutritional Surgery, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China
Corresponding author: WANG Qiang, E-mail: wangq@sj-hospital.org
Abstract    Objective    To assess the safety and short-term value of laparoscopic radical gastrectomy in the elderly with gastric cancer. Methods    From January 2010 to June 2012, elderly (Age≥60 years)with gastric cancer were performed radical operations in the Department of Gastrointestinal and Nutritional Surgery of Shengjing Hospital Affiliated to China Medical University. The differences of intraoperative and postoperative situation, postoperative complications, and short-term survival rates between laparoscopy and open radical gastrectomy group were analyzed. The risk factors that determined postoperative complications were investigated by univariate and multivariate analysis. Results    Among patients, 102 patients received laparoscopy-assisted gastrectomy (LAG group) and 242 patients underwent open gastrectomy (OG group). There was no significant difference in the operative time and the mean number of retrieved lymph nodes between two groups (P>0.05). In the aspects of intraoperative blood loss, frequency of active anodyne using, length of incision, first flatus and postoperative hospital stays, the LAG group showed distinctive advantage than the OG group with the significant difference statistically (χ2=4.106，P=0.043). The rate of postoperative complications in LAG group and OG group were16.7% and 26.9% and the difference was significant (P<0.05). By logistic regression analysis, it showed that there were three significant factors for postoperative complications including laparoscopy-assisted gastrectomy or not, operative time and co-morbidity. Three hundred and thirteen patients (91.0%) were followed up for 6 to 36 months. The median time was 19 months. As for the survival curves, the survey showed there was no significant difference between two groups (P>0.05). Conclusion    Laparoscopy-assisted radical gastrectomy is safe and feasible in elderly, which presents the superior character of minimal invasion and profit decreasing postoperative complications.