Laparoscopic versus open resection for elderly patients with gastric cancer: a double-center study with propensity score
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ORIGINAL ARTICLE
Laparoscopic versus open resection for elderly patients with gastric cancer: a double-center study with propensity score matching method Wei-Zhe Chen 1 & Qian-Tong Dong 1 & Feng-Min Zhang 1 & Hui-Yang Cai 1 & Jing-Yi Yan 1 & Cheng-Le Zhuang 2 & Zhen Yu 2 & Xiao-Lei Chen 1,3 Received: 2 March 2020 / Accepted: 25 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The applicability of laparoscopic-assisted radical gastrectomy for elderly patients with gastric cancer is still not well clarified. The aim of this double-center study was to explore the feasibility and effectiveness of laparoscopic-assisted radical gastrectomy on elderly patients with gastric cancer. Methods We prospectively collected data of patients who underwent gastrectomy for cancer in two centers from June 2016 to December 2019. Propensity score matching was performed at a ratio of 1:1 to compare the laparoscopic-assisted radical gastrectomy group and open radical gastrectomy group. Univariate analyses and multivariate logistic regression analyses evaluating the risk factors for total, surgical, and medical complications were performed. Results A total of 481 patients with gastric cancer met the inclusion criteria and were included in this study. After propensity score analysis, 258 patients were matched each other (laparoscopic-assisted radical gastrectomy (LAG) group, n = 129; open radical gastrectomy (OG) group, n = 129). LAG group had lower rate of surgical complications (P = 0.009), lower rate of severe complications (P = 0.046), shorter postoperative hospital stay (P = 0.001), and lower readmission rate (P = 0.039). Multivariate analyses revealed that anemia, Charlson comorbidity index, and combined resection were independent risk factors in the LAG group, whereas body mass index and American Society of Anesthesiology grade in the OG group. Conclusion Laparoscopic-assisted radical gastrectomy was relative safe even effective in elderly gastric cancer patients. We should pay attention to the different risk factors when performing different surgical procedures for gastric cancer in elderly patients. Keywords Gastric cancer . Elderly . Laparoscope . Postoperative complications . Propensity score matching
Introduction Wei-Zhe Chen and Qian-Tong Dong have contributed equally to this work and are co-first authors on this work. * Zhen Yu [email protected] * Xiao-Lei Chen [email protected] 1
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
2
Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai 20072, China
3
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, The South of Shangcai Village, Ouhai District, Wenzhou 325005, Zhejiang Province, China
As one of the means of minimally invasive surgery, laparoscopic surgery has many advantages, such as lower intraoperative blood loss, fa
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