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BACKGROUND: The data are scarce on the outcome for elderly patients presenting with resectable gastric cancer in the West who have been treated with minimally invasive surgery. This report presents the authors' early experience with totally laparoscopic gastric resections for cancer in elderly patients. METHODS: A total of 20 patients underwent laparoscopic gastrectomy procedures: 14 distal, 5 subtotal, and 1 total gastrectomy. The male-to-female ratio was 15 to 5. The ages ranged from 75 to 88 years (mean, 80 years). RESULTS: All cases were managed laparoscopically with R0 resection. Four patients needed high-dependency unit care postoperatively. There were no perioperative deaths. The median time required for the procedure was 212 min, and time to diet was 4 days. The hospital stay was 8 days. Four patients experienced significant complications, with two patients requiring reoperation. The pathology was adenocarcinoma for 17 patients and high-grade dysplasia for 3 patients. CONCLUSION: Among elderly patients for whom conventional gastric surgery carries a high morbidity and mortality risk, minimal access surgery may offer equivalent oncologic integrity but with superior safety and economy. The primary aim is to remove the tumor with at least a D1 lymphadenectomy.

Original publication

DOI

10.1007/s00464-007-9561-9

Type

Journal article

Journal

Surg Endosc

Publication Date

04/2008

Volume

22

Pages

1002 - 1007

Keywords

Adenocarcinoma, Aged, Aged, 80 and over, Female, Gastrectomy, Humans, Laparoscopy, Lymph Node Excision, Male, Postoperative Complications, Stomach Neoplasms, Treatment Outcome