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.