| Objective:To evaluate the safety and short-term effect of laparoscopic surgery for distal advanced gastric cancer in elderly patients.Methods:The clinical data of elderly patients who suffered from distal advanced gastric cancer were collected by our department from September2008to March2012.31patients received laparoscopy gastrectomy, while35patients received open radical gastrectomy. Evaluate relevant indicators during and after the surgery. The factors affecting postoperative complications in laparoscopy group were analyzed by logistic regression analysis. The factors affecting the postoperative hospitalization days in laparoscopy group were analyzed by multiple linear regression analysis.Results:1. In terms of operation time (226.94±51.21min vs203.43±57.80min) and numbers of dissected lymph node(31.74±16.25vs29.37±20.58), the differences between two groups have no stastical significance(p>0.05). In terms of the blood transfusion rate during surgery (9.7%vs37.1%), intraoperative blood loss (151.29±40.39ml vs224.29±110.06ml)and incision length (6.03±0.75cm vs15.23±1.80cm), the laparoscopic surgery group has more advantages than open surgery group (p<0.05).2. In terms of first flatus time(4.06±1.03d vs5.09±1.54d), removing the gastric tube time (5.23±1.12d vs6.09±1.31d), removing the drainage tube time(7.52±3.84d vs9.54±3.25d), first receiving liquid diet time (7.06±1.34d vs9.09±2.01d)and the hospitalization days (15.23±2.70d vs18.40±7.01d), laparoscopic surgery group is shorter than open surgery group (p<0.05). In terms of the intensive medicine hospital admission rates (3.2%vs8.6%),the complications rates (22.6%vs20.0%) had no significant difference between two groups(p>0.05).3. All patients were followed up for2-24months.Survival rates of the two groups had no significant difference (being87.1%vs82.9%respectively). 4. The logistic regression analysis revealed that whether having preoperative comorbidity and intraoperative blood loss were the risk factors of postoperative complications.5. The multiple linear regression analysis revealed that there were two main factors affecting postoperative hospitalization days, namely age and intraoperative blood loss.Conclusions:1. Laparoscopic surgery for elderly patients with distal advanced gastric cancer is safe and effctive. Its radical effect and short-term survival rates are equal to open surgery group.2. Laparoscopic surgery for elderly patients with distal advanced gastric cancer has minimally invasive advantages,such as less trauma, less bleeding, faster recovery after surgery.3. The complications before surgery and the bleeding quantity after surgery are independent risk factors which affect whether the complications after surgery will occur in laparoscope group.4. Age and bleeding quantity during surgery are the main factors which will affect the hospitalization days in laparoscope group. |
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