| Objective: To investigate the safety,short-term efficacy and postoperative quality of life of laparoscopic surgery for elderly patients with advanced gastric cancer.Methods: A retrospective analysis was used to compare 40 elderly patients(≧60 years old)who underwent laparoscopy-assisted distal gastrectomy(LADG)from January 2012 to December 2015 at the First Affiliated Hospital of Xiamen University,And 46 elderly patients(≧ 60 years old)who underwent traditional open distal gastrectomy(ODG).The surgical indexes of laparoscopic group(LADG group)and open group(ODG group)were collected: operation time,intraoperative blood loss,intraoperative blood transfusion,length of skin incision,reconstruction of digestive tract,postoperative recovery index: postoperative lower Time,postoperative venting time,fluid intake time,number of postoperative analgesia,postoperative hospital stay,postoperative complications,oncological outcomes: number of lymph node dissections,number of positive lymph nodes,tumor stage(TNM stage),and follow-up The two-year survival time and quality of life of the two groups of patients.SPSS.20 software was used to statistically analyze the data of the two groups.P<0.05 represents statistical significance.Results: The laparoscopic group had intraoperative hemorrhage(110.50±75.58 ml vs.233.70±130.41ml),intraoperative blood transfusion(3/40 vs.11/46),incision length(7.23±1.00 cm vs.17.04±1.83cm),and time of hypothermia(1.55±0.68 day vs.3.46±1.15 days),anal exhaust time(4.13±1.18 days vs.5.07±1.34 days),fluid intake(5.60±1.41 days vs.7.65±1.88 days),the number of analgesia(0.65±0.58 times vs.1.30±1.09 times)and hospital stay(14.28±3.80 days vs.16.43±5.28 days)were superior to those in open group(P<0.05).Laparoscopic group was longer than open group at operation time(266.95±41.96 min vs.233.20±43.77 min,P<0.05),while the laparoscopic group wasreconstructed in the digestive tract(Birol-I 2 cases,Birol-II 33 cases,Roux-en-Y 5 cases,vs.Biro-I 3 cases,There were 40 patients with Billow-II,3 with Roux-en-Y),complications(10/40 vs.17/46),lymph node dissection(31.48±11.25 vs.33.22±9.10),and positive lymph node number(5.63±7.89 vs.8.15 ± 9.15)and tumor stage(6 in stage I,15 in stage II,19 in stage III,vs.4 in stage I,13 in stage II,and 29 in stage III)were not significantly different from those in laparotomy(P>0.05),and the laparoscopic group and open group were no significant difference in postoperative two-year overall survival(24/35 vs.26/39)and quality of life such as Dysphagia scale,Pain scale,Reflux symptoms scale,Eating restrictions scale,anxiety scale,having a dry mouth,taste change,body image,and hair loss(P>0.05).Conclusion: Laparoscopy-assisted distal gastrectomy(LADG)for the treatment of advanced gastric cancer in elderly patients has a minimally invasive effect such as less bleeding,faster recovery of gastrointestinal function,and less pain.Although the operation takes a long time,it does not increase the incidence of postoperative complications.It has the same effect as laparotomy in the aspects of radical resection,short-term survival rate and 2-year quality of life. |
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