Laparoscopic distal gastrectomy in old-old patients: the first Western experience

BACKGROUND: This is the first Western study presenting short-term results on patients older than 80years affected by gastric cancer and treated with laparoscopic distal gastrectomy.METHODS: A multicentre prospective database on patients suffering from distal gastric cancer with age of≥80 undergone to distal gastrectomy was analysed retrospectively. End points were length of hospital stay (LoS) after surgery, and times to stool passage and solid diet initiation, as well as postoperative complications. Univariate analysis of the differences between "laparoscopic" and "open" groups was performed with non-parametric tests.RESULTS: Forty-six patients (median age: 83years, median CCI: 5) undergone to distal gastrectomy were analysed. Seventeen out 46 patients (36.9%) underwent laparoscopic distal gastrectomy and extended lymphadenectomy was achieved in 25 cases (25/46, 54.3%). Median number of removed and examined nodes was higher in laparoscopic than in open group. Median LoS was significantly lower in the laparoscopic group (8 vs. 11days). Complications occurred in 12 patients (26.1%): no significant differences between the two groups. There was a significant difference between the two surgical approaches in term of times for stool passage.CONCLUSIONS: Laparoscopic approach seems to reduce the effect of the surgical trauma without compromising lymphadenectomy also in octogenarian patients with distal gastric cancer.