Laparoscopy-assisted Radical Gastrectomy With D2 Lymph Node Dissection For Gastric Cancer In The Elderly

Objective To evaluate the feasibility and efficacy of laparoscopy-assisted radical gastrectomy with D2 lymph node dissection for elderly patients with gastric cancer. Methods From January 2007 to December 2009, 255 gastric cancer patients over 65 years underwent D2 lymph node dissectin. Of these, 116 patients underwent laparoscopy-assisted radical gastrectomy (LAG group), while 139 patients underwent conventional open gastrectomy (OG group). The recovery and complication rate were compared between two groups. The risk factors that determined postoperative complications were investigated by univariate and multivariate analyses. Results All patients were followded up for 2-48 months. The follow-up rate was 92.5%, with 236 cases involved. There were no significant difference in survival curve between the two groups(P>0.05). The operation time and the mean number of removal lymph node were not significantly between two groups. However, compared to OG group, the mean blood loss and number of patients needed blood transfusion were less, and first flatus time, time to resume soft diet and postoperative hospital stay were shorter in LAG group(all P<0.05). The postoperative morbidity in LAG group and OG group were 15.5% and 28.1%, respectively(P<0.05). By logistic regression analysis, it was revealed that there were three significant factors for postoperative complications such as laparoscopy-assisted gastrectomy or not, operation time and preoperative comorbidity.Conclusions Laparoscopy-assisted radical gastrectomy with D2 lymph node dissection is oncologically compatible with open gastrectomy in elderly patients with gastric cancer. It is not only a less invasive procedure, but also a protective factor for postoperative comorbidity.