Abstract
BackgroundThe aim of this study was to investigate the influence of patients’ age on postoperative morbidities including pneumonia.MethodsWe reviewed the clinical records of 211 patients with stages I – III gastric cancer undergoing curative distal gastrectomy (DG) or total gastrectomy (TG). Patients were classified into an elderly (≧80 y.o.) or a control (< 80 y.o.) group. We compared patient characteristics (sex ratio, disease stage, degree of lymph node dissection, number of retrieved lymph nodes, and type of reconstruction) and early postoperative outcomes (operation time, intra-operative blood loss, and postoperative morbidity including pneumonia, and mortality) between the two groups separately in DG and TG.ResultsThere were 134 and 77 patients who underwent DG and TG, respectively. The numbers of patients in the elderly and control groups were 25 and 109 in DG and 12 and 65 in TG. The percentage of female patients in the elderly group was greater than that in the control group in both DG and TG. The extent of lymph node dissection did not differ between two groups in TG; in contrast in DG, the rate of a D1 dissection was greater in the elderly group than in the control group. There were no differences between the two groups in distribution of disease stage, number of retrieved lymph nodes, operation time, and blood loss in DG and in TG. Overall postoperative morbidity did not differ between two groups after DG and after TG. The rate of infectious complications in the elderly group was not different from that in the control group after DG and after TG. The incidence of pneumonia was more frequent in the elderly group compared to the control group after DG (8% vs. 1%, P < 0.05) but not after TG (17% vs. 5%). When patients were compared between the elderly and the control groups regardless of type of gastrectomy, the incidence of pneumonia in the elderly group (4/37 (11%)) was greater than that in the control group (4/174 (2%), P < 0.05).ConclusionsThese results suggest that pneumonia is increased in patients older than 80 years after DG.
Highlights
The aim of this study was to investigate the influence of patients’ age on postoperative morbidities including pneumonia
The rate of pneumonia in infectious complications was increased in the elderly group (4/5 (80%)) compared to that in the control group (4/20 (20%), P < 0.05) (Table 1)
In the present study, we found that postoperative pneumonia (8%) in elderly patients was increased compared to the younger control group (1%) after distal gastrectomy (DG), but not after total gastrectomy (TG)
Summary
The aim of this study was to investigate the influence of patients’ age on postoperative morbidities including pneumonia. As the prevalence of gastric cancer increases with age [2], it is likely that the number of elderly patients with gastric cancer requiring gastrectomy will not decrease but rather increase in a country like Japan. A considerable number of articles have been published in term of overall postoperative complications in elderly patients including postoperative pneumonia [3,4,5,6,7,8,9,10]. Some other studies investigated if age was a risk factor for postoperative complications or pneumonia [11,12,13] It remains controversial, whether or not overall postoperative morbidity as well as pneumonia is increased after gastrectomy in elderly patients. Few articles have studied postoperative complications in elderly patients after distal gastrectomy (DG) and total gastrectomy (TG) separately
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