Total gastrectomy with “over-D1” lymph node dissection: what is the actual impact of age? - 08/11/12
Abstract |
Background |
We aimed to evaluate risk factors for postoperative complications after total gastrectomy with “over-D1” lymphadenectomy.
Methods |
Data on 161 patients (54 cases aged >75 years: elderly group) operated on between 2005 and 2011 were reviewed. Risk factors analyzed for complications (Clavien-Dindo classification) included sex, age, American Society of Anesthesiologists (ASA) grade, body mass index (BMI), pTNM stage, long-term antiplatelets therapy, operative time, and splenectomy.
Results |
The median age of the study population was 71 (interquartile range [IQR] 62–77) years (79 [range 76–90] years for elderly patients vs 65 [range 33–75] years for the control group, P < .0001). ASA classification was the only baseline characteristic significantly different in the intergroup analysis; 79.6% of the elderly patients were in ASA class III to IV versus 39.2% of the controls (P < .0001). Univariate analysis showed that patient age, ASA score, BMI, and splenectomy were predictive of postoperative complications. Multivariate analysis confirmed ASA score and splenectomy as independent risk-factors.
Conclusions |
Regardless of age, fit elderly patients with operable gastric cancer should be candidates for the recommended standard extensive surgical resection provided that pre-existing comorbidities are considered.
Le texte complet de cet article est disponible en PDF.Keywords : Gastric cancer, Old age, Total gastrectomy, Clavien-Dindo classification, Over-D1 lymph node dissection
Plan
Vol 204 - N° 5
P. 732-740 - novembre 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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