Influence of age on postoperative complications especially pneumonia after gastrectomy for gastric cancer.


Journal

BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567

Informations de publication

Date de publication:
08 Aug 2019
Historique:
received: 21 12 2018
accepted: 01 08 2019
entrez: 10 8 2019
pubmed: 10 8 2019
medline: 28 11 2019
Statut: epublish

Résumé

The aim of this study was to investigate the influence of patients' age on postoperative morbidities including pneumonia. We 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. There 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). These results suggest that pneumonia is increased in patients older than 80 years after DG.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this study was to investigate the influence of patients' age on postoperative morbidities including pneumonia.
METHODS METHODS
We 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.
RESULTS RESULTS
There 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).
CONCLUSIONS CONCLUSIONS
These results suggest that pneumonia is increased in patients older than 80 years after DG.

Identifiants

pubmed: 31395044
doi: 10.1186/s12893-019-0573-x
pii: 10.1186/s12893-019-0573-x
pmc: PMC6686256
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106

Références

Lancet Infect Dis. 2004 Feb;4(2):112-24
pubmed: 14871636
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
World J Surg. 2006 Aug;30(8):1468-74
pubmed: 16850149
Gastric Cancer. 2007;10(1):39-44
pubmed: 17334717
Clin Gastroenterol Hepatol. 2007 Dec;5(12):1392-8
pubmed: 17936081
World J Surg. 2008 Jun;32(6):1045-50
pubmed: 18324344
Ann Surg Oncol. 2008 Oct;15(10):2692-700
pubmed: 18663532
Gastric Cancer. 2011 Jun;14(2):101-12
pubmed: 21573743
Lung. 2012 Feb;190(1):29-33
pubmed: 22033612
J Gastric Cancer. 2011 Jun;11(2):116-21
pubmed: 22076212
World J Surg. 2012 Mar;36(3):632-7
pubmed: 22270979
J Gastrointest Surg. 2012 Apr;16(4):728-37
pubmed: 22350724
World J Surg. 2012 Jul;36(7):1632-9
pubmed: 22407085
Int J Surg. 2013;11(6):467-71
pubmed: 23602896
Aging Clin Exp Res. 2013 Jun;25(3):239-45
pubmed: 23740581
World J Surg. 2013 Dec;37(12):2891-8
pubmed: 24081528
Ann Surg Oncol. 2014 Sep;21(9):3008-14
pubmed: 24700300
Surg Infect (Larchmt). 2014 Jun;15(3):314-21
pubmed: 24796353
Gastric Cancer. 2015 Jul;18(3):653-61
pubmed: 24874161
Jpn J Infect Dis. 2014;67(4):269-75
pubmed: 25056072
World J Surg Oncol. 2014 Aug 21;12:269
pubmed: 25141903
Surg Endosc. 2015 Nov;29(11):3196-204
pubmed: 25582964
J Surg Oncol. 2015 Jun;111(7):848-54
pubmed: 25753213
Ann Surg Oncol. 2015 Dec;22(13):4371-9
pubmed: 25822782
Surg Today. 2016 May;46(5):552-6
pubmed: 26077287
J Surg Oncol. 2015 Sep;112(4):387-95
pubmed: 26303645
Eur J Surg Oncol. 2016 Feb;42(2):303-11
pubmed: 26710992
Gastric Cancer. 2017 Jan;20(1):1-19
pubmed: 27342689
Surg Today. 2018 Aug;48(8):773-782
pubmed: 29536199
Chest. 1995 Feb;107(2):453-6
pubmed: 7842777
Ann Surg. 1997 Nov;226(5):613-20
pubmed: 9389395

Auteurs

Chikashi Shibata (C)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan. cshibata@tohoku-mpu.ac.jp.

Hitoshi Ogawa (H)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Toru Nakano (T)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Kaori Koyama (K)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Kuniharu Yamamoto (K)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Munenori Nagao (M)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Daisuke Takeyama (D)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Kazuhiro Takami (K)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Akihiro Yasumoto (A)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Tomohiko Sase (T)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Shun-Ichi Kimura (SI)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Kentaro Sawada (K)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Yu Katayose (Y)

Division of Gastroenterologic and Hepato-biliary-pancreatic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH