Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Optimizing postsurgical recovery for elderly patients with gastric cancer

Based on a recent study by Li et al,this editorial examines the significance of enhanced recovery after surgery(ERAS)protocols for elderly patients with gastric cancer.Cancer-related mortality,which is overwhelmingly caused by gastric cancer,calls for effective treatment strategies.Despite advances in the field of oncology,conventional postoperative care often results in prolonged hospital stays and increased complications.The aim of ERAS is to expedite recovery,reduce surgical stress,and improve patient satisfaction.The study of Li et al showed that,compared to traditional care,ERAS significantly reduces mortality risk,shortens hospital stays,and decreases postoperative complications.These findings support the widespread implementation of ERAS protocols in surgical practice to enhance patient outcomes and healthcare value.

Preoperative malnutrition in elderly gastric cancer patients and adverse postoperative outcomes of radical gastrectomy

Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer(GC).Malnutrition is closely linked to high rates of postoperative complications and poor wound healing in elderly GC patients,which may lead to a higher incidence and mor-tality rate of GC.Malnutrition decreases the physical function of elderly GC patients after surgery,severely affecting their postoperative life quality and hindering subsequent treatments.This retrospective study was conducted by Zhao et al,focusing on the clinical baseline data,postoperative complications,and hospitalization times of elderly GC patients who underwent curative gastrectomy.Additionally,the underlying causes of poor outcomes for patients were discussed.This study may provide a solid basis for the clinical treatment of elderly GC patients in the future.Therefore,malnutrition can serve as a negative prognostic factor for curative surgery in GC patients.Addressing malnutrition and its adverse effects can benefit elderly GC patients from surgical treatment.

Comparison of short-term efficacy between totally laparoscopic gastrectomy and laparoscopic assisted gastrectomy for elderly patients with gastric cancer

BACKGROUND Totally laparoscopic gastrectomy(TLG)entails both gastrectomy and gastrointestinal reconstruction under laparoscopy.Compared with laparoscopic assisted gastrectomy(LAG),TLG has been demonstrated in many studies to require a smaller surgical incision,result in a faster postoperative recovery and less pain and have comparable long-term efficacy,which has been a research hotspot in recent years.Whether TLG is equally safe and feasible for elderly patients remains unclear.AIM To compare the short-term efficacy of and quality of life(QOL)associated with TLG and LAG in elderly gastric cancer(GC)patients.METHODS The clinicopathological data of 462 elderly patients aged≥70 years who underwent LAG or TLG(including distal gastrectomy and total gastrectomy)between January 2017 and January 2022 at the Department of General Surgery,First Medical Center,Chinese PLA General Hospital were retrospectively collected.A total of 232 patients were in the LAG group,and 230 patients were in the TLG group.Basic patient information,clinicopathological characteristics,operation information and QOL data were collected to compare efficacy.Compared with those in the LAG group,intraoperative blood loss in the TLG group was significantly lower(P<0.001),and the time to first flatus and postoperative hospitalization time were significantly shorter(both P<0.001).The overall incidence of postoperative complications in the TLG group was significantly lower than that in the LAG group(P=0.01).Binary logistic regression results indicated that LAG and an operation time>220 min were independent risk factors for postoperative complications in elderly patients with GC(P<0.05).In terms of QOL,no statistically significant differences in various preoperative indicators were found between the LAG group and the LTG group(P>0.05).Compared with the laparoscopic-assisted total gastrectomy group,patients who received totally laparoscopic total gastrectomy had lower nausea and vomiting scores and higher satisfaction with their body image(P<0.05).Patients who underwent laparoscopic-assisted distal gastrectomy were more satisfied with their body image than patients in the totally laparoscopic distal gastrectomy group(P<0.05).CONCLUSION TLG is safe and feasible for elderly patients with GC and has outstanding advantages such as reducing intracorporeal blood loss,promoting postoperative recovery and improving QOL.

Is surgery the best treatment for elderly gastric cancer patients?

As the elderly population increases,the number of patients with gastric cancer has also been increasing.Elderly people have various preoperative problems such as malnutrition,high frequency of comorbidities,decreased performance status,and dementia.Furthermore,when surgery is performed,high postoperative complication rates and death from other diseases are also concerns.The goal of surgery in the elderly is that short-term outcomes are comparable to those in nonelderly,and long-term outcomes reach life expectancy.Perioperative problems in the elderly include:(1)Poor perioperative nutritional status;(2)Postoperative pneumonia;and(3)Psychological problems(dementia and postoperative delirium).Malnutrition in the elderly has been reported to be associated with increased postoperative complications and dementia,pointing out the importance of nutritional management.In addition,multidisciplinary team efforts,including perioperative respiratory rehabilitation,preoperative oral care,and early postoperative mobilization programs,are effective in preventing postoperative pneumonia.Furthermore,there are many reports on the usefulness of laparoscopic surgery for the elderly,and we considered that minimally invasive surgery would be the optimal treatment after assessing preoperative risk.

Effect of dexmedetomidine on the immune function, serum inflammatory factors and hemodynamics in elderly patients with gastric cancer

Objective: To investigate the effect of dexmedetomidine on the immune function, serum inflammatory factors and hemodynamics in elderly patients with gastric cancer. Method: A total of 84 elderly patients with gastric cancer treated in our hospital from September 2015 to March 2017 were randomly divided into the control group and the observation group, each with 42 cases. The control group received intravenous infusion of Sodium Chloride Injection before anesthesia induction, and the observation group received dexmedetomidine intravenous infusion. The levels of hemodynamic indexes HR and MAP levels, serum inflammatory factors levels of CRP, IL-2, IL-10 levels and T lymphocyte subsets levels were compared between the two groups. Results: Compared with induction of anesthesia before, the HR level of two groups were both significantly increased at 6 h after operation, the MAP level of control group was significantly increased at 6 h after operation while was not changed significantly in the observation group. According comparison between groups at 6 h after operation, the levels of HR, MAP in observation group were significantly lower than those of the control group. Compared with induction of anesthesia before, the CRP level was significantly increased at each postoperative time point in two groups;the IL-2 level at 24 h after operation of two groups were decreased significantly, while both increased back and significantly higher than that before induction of anesthesia;the IL-10 level at 24 h after operation of two groups were increased significantly, while both decreased back and significantly lower than that before induction of anesthesia. Compared with the control group at the same time point, the CRP, IL-10 level of observation group were significantly lower than those of the control group and the IL-2 level of observation group was significantly higher than that of the control group. Compared with induction of anesthesia before, the levels of CD3+, CD4+, CD4+/CD8+ of control group were significantly decreased at 6 h, 24 h, 72 h after operation and significantly decreased at 24 h after operation in observation group. 72 h after operation, the levels of CD3+, CD4+, CD4+/CD8+ of observation group increased back and were not changed significantly compared with induction of anesthesia before. Compared with the control group at the same time point, 6 h, 24 h, 72 h after operation, the levels of CD3+, CD4+, CD4+/CD8+ of observation group were significantly higher than that of the control group. Conclusion: Dexmedetomidine for elderly patients with gastric cancer assisted anesthesia can reduce the stress caused by surgical trauma, improve the immune level, reduce the inflammatory response, and stabilize hemodynamics of patients in the perioperative period significantly. It is worthy of clinical promotion.

Study on treatment and nursing of elderly patients with gastric cancer complicated with diabetes

Objective To study and analyze the treatment and nursing of elderly patients with gastric cancer complicated with diabetes.Methods:different data were analyzed and summarized.Conclusion:the elderly patients with gastric cancer and diabetes can cooperate with the control of blood glucose during the surgical treatment,and strengthen the nursing before and after the operation.

Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients

AIM: To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.METHODS: A meta-analysis was performed of a systematic search of studies on an electronic database. Studies that compared laparoscopic colectomy(LAC) in elderly colorectal cancer patients with open colectomy(OC) were retrieved, and their short and long-term outcomes compared. Elderly people were defined as 65 years old or more. Inclusion criteria were set at: Resection of colorectal cancer, comparison between laparoscopic and OC and no significant difference in backgrounds between groups.RESULTS: Fifteen studies were identified for analysis. LAC was performed on 1436 patients, and OC performed on 1810 patients. In analyses of short-term outcomes, operation time for LAC was longer than for OC(mean difference = 34.4162, 95%CI: 17.8473-50.9851, P < 0.0001). The following clinical parameters were lower in LAC than in OC: Amount of estimated blood loss(mean difference =-93.3738, 95%CI:-132.3437 to-54.4039, P < 0.0001), overall morbidity(OR = 0.5427, 95%CI: 0.4425-0.6655, P < 0.0001), incisional surgical site infection(OR = 0.6262, 95%CI: 0.4310-0.9097, P = 0.0140), bowel obstruction and ileus(OR = 0.6248, 95%CI: 0.4519-0.8638, P = 0.0044) and cardiovascular complications(OR = 0.4767, 95%CI: 0.2805-0.8101, P = 0.0062). In analyses of long-term outcomes(median follow-up period: 36.4 mo in LAC, 34.3 mo in OC), there was no significant difference in overall survival(mean difference = 0.8321, 95%CI: 0.5331-1.2990, P = 0.4187) and disease specific survival(mean difference = 1.0254, 95%CI: 0.6707-1.5675, P = 0.9209). There was also no significant difference in the number of dissected lymph nodes(mean difference =-0.1360, 95%CI:-4.0553-3.7833, P = 0.9458).CONCLUSION: LAC in elderly colorectal cancer patients had benefits in short-term outcomes compared with OC except operation time. The long-term outcomes and oncological clearance of LAC were similar to that of OC. These results support the assertion that LAC is an effective procedure for elderly patients with colorectal cancer.

Surgery for gastric cancer patients of age 85 and older: Multicenter survey

To investigate the surgical therapies for gastric cancer (GC) patients of age 85 or older in a multicenter survey.METHODSTherapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated. The relationships between surgical therapies and clinicopathological or prognostic features were analyzed.RESULTSEighty-nine of the patients (66%) presented with a comorbidity, and 26 (19% overall) presented with more than two comorbidities. Radical lymphadenectomy was performed in 59 patients (44%), and no patient received pre- or post-operative chemotherapy. Forty of the patients (30%) experienced perioperative complications, but no surgical or perioperative mortality occurred. Laparoscopic surgery was performed in only 12 of the patients (9.0%). Univariate and multivariate analyses of the 113 patients who underwent R0 or R1 resection identified the factors of pT3/4 and limited lymphadenectomy as predictive of worse prognosis (HR = 4.68, P = 0.02 and HR =2.19, P = 0.05, respectively). Non-cancer-specific death was more common in cStage I patients than in cStage II or III patients. Limited lymphadenectomy correlated with worse cancer-specific survival (P = 0.01), particularly in cStage II patients (P < 0.01). There were no relationships between limited lymphadenectomy and any comorbidities, except for cerebrovascular disease (P = 0.07).CONCLUSIONNon-cancer-specific death was not negligible, particularly in cStage I, and gastrectomy with radical lymphadenectomy appears to be an effective treatment for cStage II elderly GC patients.

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Head and neck cancer(HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach.

Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly

Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.

Newly emerging standard chemotherapies for gastric cancer and clinical potential in elderly patients

With the increase in average life expectancy,the rate of occurrence of gastric cancer in elderly patients is also rising.While many clinical trials have been conducted to examine the effect of chemotherapy treatment on gastric cancer,age limits for eligible subjects have prevented the establishment of standards for chemotherapy in elderly patients with gastric cancer.As of March 2009,evidence-based standard chemotherapy regimens were established.In the Western world,debates centered on the ECF(Epirubicin/cisplatin/5FU) or DCF(Docetaxel/cisplatin/5-FU) regimens based on the phase □ randomized controlled trial at the Royal Marsden Hospital(RMH) or the V325 study,respectively.The JCOG9912 and SPIRITS trials emerged from Japan indicating attractive regimens that include S-1 for advanced gastric cancer patients.Using these active anticancer drugs,the trials that studied the eff icacy of adjuvant therapies or surgical approaches,such as the Int-116/MAGIC/ACTS-GC trials,have actually succeeded in demonstrating the benefits of adjuvant therapies in gastric cancer patients.For cases of gastric cancer in elderly patients,treatment policies should consider these studies while analyzing not only the therapeutic effects but also drug toxicity,individual general health conditions,and social factors to select treatments that emphasize quality of life.

Distal gastric tube resection with vascular preservation for gastric tube cancer:A case report and review of literature

BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also increased.Total resection of the gastric tube with lymph node dissection is considered a radical treatment,but GTC surgery is more invasive and involves a higher risk of severe complications or death,particularly in elderly patients.CASE SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y(R-Y)reconstruction.The tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric ring.Endoscopic submucosal resection was not indicated because the primary lesion was submucosally invasive,was undifferentiated type,surrounded the pyloric ring,and had invaded the duodenum.Resection of distal gastric tube with R-Y reconstruction was safely performed,with preservation of the right gastroepiploic artery(RGEA)and right gastric artery(RGA).CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.

Morbidity and mortality of elderly patients with advanced gastric cancer after laparoscopy-assisted or open distal gastrectomy:a randomized–controlled trial

Laparoscopy-assisted distal gastrectomy(LDG)combined with D2 lymphadenectomy may be safely performed in patients with advanced gastric cancer(AGC)by experienced surgeons at specialized high-volume institutions as shown in the Chinese Laparoscopic Gastrointestinal Surgery Study(CLASS)-01.However,studies focusing on the use of LDG in patients with gastric cancer older than 65 years are rare.This study was designed to investigate the morbidity and mortality of elderly patients with gastric cancer who underwent laparoscopic-assisted or open distal gastrectomy(ODG).In this prospective,randomized,open,parallel controlled trial,patients older than 65 years with tumor located at the middle or lower part of the stomach will be enrolled in this study.Patients will be randomly divided into a laparoscopic group and an open surgery group.The early post-operative complications,intra-operative complications and post-operative recovery will be compared between the two groups.This trial will provide valuable clinical evidence for the objective assessment of the feasibility,short-term safety,and potential benefits of LDG compared with ODG for gastric cancer in the elderly patients.This trial has been registered on ClinicalTrials.gov.(Identifier:NCT02246153.)in September 22,2014.

Laparoscopic gastrectomy for elderly gastric-cancer patients:comparisons with laparoscopic gastrectomy in non-elderly patients and open gastrectomy in the elderly

Background:The benefits of laparoscopic gastrectomy(LG)in elderly gastric-cancer patients still remain unclear.The purpose of this study was to evaluate the feasibility and safety of LG in elderly gastric-cancer patients.Methods:We retrospectively evaluated patients who underwent LG or open gastrectomy(OG)between June 2009 and July 2015 in a single high-volume center.We compared surgical,short-term,and long-termsurvival outcomes among an elderly(-70 years old)LG(ELG)group(n=114),a non-elderly(<70 years old)LG(NLG)group(n=740),and an elderly OG(EOG)group(n=383).Results:Except for extended time to first flatus,the surgical and short-term outcomes of the ELG group were similar to those of the NLG group.The ELG group revealed comparable disease-specific survival(DSS)rates to the NLG group(64.9%vs 66.2%,P=0.476),although the overall survival(OS)rate was lower(57.0%vs 65.5%,P<0.001)in the ELG group than in the NLG group.The ELG group showed longer operation time than the EOG group(236.4677.3 vs 179652.2 min,P<0.001).The ELG group had less estimated blood loss(174.0688.4 vs 209.36133.8,P=0.008)and shorter post-operative hospital stay(8.362.5 vs 9.264.5,P=0.048)than the EOG group.The severity of complications was similar between the ELG and NLG groups.Multivariate analysis confirmed that LG was not a risk factor for post-operative complications.Conclusions:LG is a feasible and safe procedure for elderly patients with acceptable short-and long-term survival outcomes.

认知行为干预用于高龄胃癌患者术后谵妄护理效果评价

目的探讨认知行为干预用于高龄胃癌患者术后谵妄护理的效果。方法选取医院2022年11月至2023年11月收治的高龄(>55岁)胃癌手术患者80例,按抽签法随机分为对照组和观察组,各40例。对照组行常规护理,观察组行认知行为干预护理。结果护理后,观察组患者术后排气时间、下床活动时间、住院时间均显著短于对照组(P<0.05);术后并发症发生率显著低于对照组(P<0.05);认知功能各项评分显著低于对照组(P<0.05)。结论认知行为干预用于高龄胃癌患者的术后谵妄护理,能促使患者尽早康复,减少并发症,改善其认知功能障碍。

快速康复外科理念应用于老年进展期胃癌患者围术期的回顾性对照研究

目的探讨快速康复外科(fast-track surgery,FTS)理念在老年人进展期胃癌患者术后康复的安全性和有效性。方法回顾性纳入2013年1月~2016年6月间河南科技大学第一附属医院胃肠肿瘤外科收治的122例老年(年龄≥60岁)进展期胃癌患者,其中围术期按照快速康复外科理念管理65例,按照传统管理57例。比较两组手术情况、术后恢复情况及应激程度。结果 FTS组较对照组术中麻醉时间、输液量均减少、术后通气时间提前、术后住院时间缩短、住院费用降低(P<0.05)且白细胞计数和C反应蛋白等应激指标均降低(P<0.05),两组的手术时间、术中出血量、清扫的淋巴结数和肠梗阻、感染、吻合口瘘等术后并发症率差异无统计学意义(P>0.05)。结论 FTS用于老年进展期胃癌患者围术期管理方法安全可行,值得临床推广。

细节化护理管理在老年胃癌手术患者围术期中的应用研究

目的 探讨细节化护理管理在老年胃癌手术患者围术期的应用效果.方法 选择2011年1月～2013年1月在我院手术室择期实施胃癌手术的65岁及以上患者66例作为观察对象,根据干预措施不同分为干预组和对照组各33例,比较两组患者的围术期各项护理质量管理评分、术后SAS评分、SDS评分、术后症状自评量表（SCL-90）各项评分.结果 干预组患者的护理质量管理总评分（96.2±1.7）,明显高于对照组（72.3±10.8）（P＜ 0.05）.干预组患者术后SAS、SDS评分分别较对照组明显降低（P＜0.05）.干预组患者术后躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他各项评分较对照组比较明显低于对照组（P＜0.05）.结论 细节化护理管理有利于提高护理质量,改善患者的负性心理状态,使其积极配合手术.

老年人胃癌49例手术治疗分析

目的 探讨老年人胃癌围手术期处理的有关问题及适当的手术治疗方式。方法 回顾性分析1993-1998年我院收治70岁以上老年人胃癌53例,其中施行手术49例的临床资料和手术疗效。结果老年人胃癌起病隐匿,症状多无特异性。术前多数合并有其它疾病;手术证实多数为中晚期胃癌,癌肿多见于幽门窦（77.5％）。大于5cm并累及胃浆膜层（81.6％）。病理检查多分分化型腺癌（73.4％）。49例中30例行胃癌切除术,切除率为61.2％;其中根治性切除8例（17％）,姑息性切除22例（45％）。其它手术19例（胃-空肠吻合术13例,手术探查取活检6例）。围手术期死亡率2.7％。手术后并发症27例（55％）。根治性切除术后5年生存率2.5％,姑息性切除术后五年生存率为零。结论 老年人胃癌有其特殊性,其围手术期处理至关重要,手术根治性切除率低。手术方式应根据病情而定,对早期或中期胃癌争取行D2以内的胃癌根治术。术前充分准备,提高病人手术耐受能力,手术时间以不超过2h为好,术毕常规残留或空肠造瘘,以期减少术后并发症。术后加强管理,并辅以腹腔灌注化疗,对提高病人生活质量,延长生存期有明显帮助。

全腹腔镜胃癌根治术在高龄患者手术中的安全性与可行性分析

目的评价高龄患者全腹腔镜胃癌根治术的安全性与可行性。方法回顾分析2011年3月至2017年10月72例行胃切除术高龄(≥70岁)胃癌患者的临床资料,其中34例行腹腔镜手术(A组),38例行开放手术(B组),通过分析2组术前ASA评分、术后TNM分期、手术耗时、术中出血量、术前及术后心肺功能、术中气道压力、术后胃肠道功能恢复时间、术后并发症、标本淋巴结阳性率,比较两种手术方式的安全性。结果 2组患者术前ASA评分、术后TNM分期、手术耗时差异无统计学意义(P>0.05)。患者术中心功能(心脏指数、射血分数)、肺功能(动脉血Pa CO2、p H值)腹腔镜手术组较开放手术组增高(P<0.05),患者术后24 h心肺功能2组间差异无统计学意义(P>0.05)。2组患者间术中气道压力差异有统计学意义(P<0.05),腹腔镜手术组明显高于开放手术组(P<0.05)。腹腔镜组术后排气时间、术后住院时间显著少于开腹组(P<0.05);术中出血量、手术后并发症开腹组明显高于腹腔镜组,差异有统计学意义(P<0.05);术后病理淋巴结数目、阳性率2组间差异无统计学意义(P>0.05)。平均随访15个月,腹腔镜组和开腹组患者总生存率分别是56.1%和57.9%(P>0.05)。结论高龄患者接受腹腔镜胃癌根治术较开放手术具有出血少、术后胃肠道功能恢复快的优势,具有良好的安全性及可行性。