Risk factors for postoperative pneumonia after laparoscopic gastrectomy in patients aged 75 years and over with gastric cancer

Ryuichiro Kimura, Taiki Moriyama, Kenoki Ohuchida, Koji Shindo, Shuntaro Nagai, Ohtsuka Takao, Masafumi Nakamura

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

INTRODUCTION: The proportion of patients aged 75 years and over who undergo minimally invasive surgery for gastric cancer is increasing. However, the safety and feasibility of laparoscopic gastrectomy (LG) in this age group is controversial. This study aimed to evaluate whether LG is safe and effective in patients aged 75 years and over. METHODS: The study included 728 patients with early and advanced gastric cancer who underwent curative LG between 2009 and 2017; 166 of these patients (22.8%) were aged 75 or over. All surgeries were performed laparoscopically. Selected clinical factors were compared between the 166 patients aged 75 years and over and the 562 patients aged under 75 years. RESULTS: There were significant differences in presence of comorbidity, respiratory function and American Society of Anesthesiologists physical status scores between the older and younger groups. The older patients more frequently developed complications than the younger ones, particularly postoperative pneumonia. According to multivariate analyses of all participants, age, chronic obstructive pulmonary disease (COPD), and D2 lymphadenectomy were independent risk factors for postoperative pneumonia. Advanced stage and D2 lymphadenectomy were independent risk factors in the older group, whereas only COPD was an independent risk factor in the younger group. CONCLUSIONS: LG for gastric cancer can be safely performed in patients aged over 75 years with an acceptable complication rate. However, the present data suggest that care should be taken in selecting LG with D2 lymphadenectomy to treat advanced cancer in these patients because the risk of postoperative complications, especially postoperative pneumonia, increases.

Original languageEnglish
Pages (from-to)408-416
Number of pages9
JournalAsian journal of endoscopic surgery
Volume14
Issue number3
DOIs
Publication statusPublished - Jul 1 2021

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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