Problems and Settlement of Surgery for Elderly Patients with Gastric Cancer -Based on Experience with Patients Over 85 Years Old-

Yoshihide Otani, Koichiro Kumai, Tetsuro Kubota, Masahiro Ohgami, Noritaka Hayashi, Hiroto Ishizuka, Masaki Kitajima

Department of Surgery, School of Medicine, Keio University

Since 1984, 1554 gastrectomies have been performed in Keio University Hospital and 16 patients (1%) were over 85 years old. In order to clarify and solve the problems concerning the surgical treatment of gastric cancer in elderly patients, we have reviewed the clinicopathological records of these patients. Eight out of 19 lesions were early cancers. The ratio of the types of gastrectomy such as total/distal/ proximal/wedge was 3/11/1/1. Postoperative complications such as respiratory problems and deterioration of mental status were commonly observed. The average postoperative stay was 35.4 days. Two hospital deaths occurred. In conclusion, gastrectomy for elderly patients can be performed safely with careful pre- and post operative care. Physical and mental support by family members seemed to be important. An extended radical operatoin should be performed only for selected cases, and minimally invasive surgery such as endoscopic and laparoscopic surgery can be performed with relatively extended indication.

Key words
gastric cancer, elderly patient, laparoscopic surgery

Reprint requests
Yoshihide Otani Department of Surgery, School of Medicine, Keio University
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
June 12, 1996

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