Influence of age on postoperative complications especially pneumonia after gastrectomy for gastric cancer
Influence of age on postoperative complications especially pneumonia after gastrectomy for gastric cancer
复制标题
DOI：
10.1186/s12893-019-0573-x
复制
发表时间：
2019-08-08
期刊：
影响因子：
1.9
通讯作者：
Katayose, Yu
中科院分区：
文献类型：
--
作者：
Shibata, Chikashi;Ogawa, Hitoshi;Katayose, Yu
本研究的目的是调查患者年龄对术后并发症（包括肺炎）的影响。方法回顾性分析211例Ⅰ ~ Ⅲ期胃癌患者行根治性远端胃切除术（DG）或全胃切除术（TG）的临床资料。将患者分为老年人（>= 80岁）或对照（< 80岁）组我们比较了DG和TG两组患者的特征（性别比、疾病分期、淋巴结清扫程度、回收淋巴结数量和重建类型）和早期术后结局（手术时间、术中失血量和术后并发症（包括肺炎）和死亡率）。结果134例患者接受了DG治疗，77例患者接受了TG治疗。老年组和对照组的患者数量分别为25例和109例（DG），12例和65例（TG）。老年组女性患者DG和TG均高于对照组。TG中两组之间的淋巴结清扫程度没有差异;相比之下，DG中老年组的D1清扫率高于对照组。两组在DG和TG的疾病分期分布、淋巴结回收数量、手术时间和失血量方面无差异。DG和TG后两组的总体术后发病率无差异。老年组感染性并发症发生率在DG和TG后与对照组无差异。老年组DG后肺炎发生率高于对照组（8% vs.1%，P < 0.05），但TG后无差异（17% vs.5%）。老年组与对照组比较，无论胃切除术类型如何，老年组肺炎发生率（4/37（11%））高于对照组（4/174（2%），P < 0.05）。结论80岁以上老年人DG后肺炎发生率增加。
Background The aim of this study was to investigate the influence of patients' age on postoperative morbidities including pneumonia. 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 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 These results suggest that pneumonia is increased in patients older than 80 years after DG.