AI Article Synopsis

  • - The study evaluates the short-term outcomes of older adults (75+) with locally advanced gastric cancer who had either open distal gastrectomy (ODG) or laparoscopic distal gastrectomy (LDG), using a method called propensity score matching.
  • - After analyzing 121 patients, results showed that although LDG had a longer surgical time, it resulted in significantly less blood loss and fewer serious postoperative complications compared to ODG.
  • - The findings suggest that LDG is a safe and effective surgical option for older patients, potentially offering better short-term recovery and lower rates of postoperative issues than ODG.

Article Abstract

Introduction: This study compared the short-term outcomes of older adult patients with locally advanced gastric cancer who underwent open distal gastrectomy (ODG) with those who underwent laparoscopic distal gastrectomy (LDG) using propensity score matching analysis.

Methods: Overall, 341 consecutive older adult patients aged 75 years with gastric cancer who underwent ODG or LDG between January 2013 and December 2020 were retrospectively assessed. Among them, 121 patients with locally advanced gastric cancer were included. To compare short-term outcomes, a 1:1 propensity score matching analysis was performed.

Results: After matching, 29 patients were included in both groups. Compared with the ODG group, the LDG group had a longer operative time (mean, 290 vs. 190 min; p < .0001) and lower estimated blood loss (mean, 39 vs. 223 mL; p < .0001). Overall postoperative complications of grade 2 and higher were observed in 2 (6.9%) and 12 (41%) patients in the LDG and ODG groups, respectively (p = .0046). Of these, the LDG group had a significantly lower incidence rate of infectious complications than the ODG group (3.4% vs. 27.6%; p = .025). Furthermore, in multivariate analysis, the laparoscopic approach was an independent protective factor against postoperative complications (p = .029).

Conclusions: LDG is safe and feasible for locally advanced gastric cancer in patients aged ≥75 years. Moreover, it may be a promising alternative to ODG with better short-term outcomes, including significantly lower incidence rates of postoperative complications.

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http://dx.doi.org/10.1111/ases.13371DOI Listing

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