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Abstract

【はじめに】高齢者に対する腹腔鏡下幽門側胃切除術(以下TLDG)の安全性とその有用性は確立されていない. 本論文では, 76歳以上の高齢者に対するTLDG の安全性と有効性を75 歳以下の症例と比較検討した. 【症例】2005 年4 月〜2009 年3 月までの間に行われた完全鏡視下幽門側胃切除138例のうち, 76 歳以上20例と75 歳以下の118 例について, 術中・術後合併症, 術後経過などについて比較した. 【結果】術前のASA status は高齢者群で有意に悪く(P= 0.013), 高血圧と呼吸疾患の合併は高齢者で多かった(P= 0.032/P= 0.005). 術中の出血量や手術時間, 入院日数などに両者の違いはなかった. 術後合併症は, 重症なものは両者に違いはなかったが, 創感染など軽微なものが高齢者に多かった. 術後1 年後の体重減少率や血液データなどに両者の違いは認められなかった. 【結語】背景因子には違いはあるが, 高齢者のTLDG は若年者と変わらず安全に施行可能であると考えられる.

Introduction : This study evaluated the feasibility of totally laparoscopic distal gastrectomy (TLDG) in elderly patients with gastric cancer. Methods : We retrospectively analyzed the data from 138 patients who underwent TLDG from April 2005 to March 2009. Of these 138 patients, 20 were older than 75 years of age, and 118 were 75 years of age or younger. Results : The preoperative respiratory function and American Society of Anesthesiologists (ASA) -physical status were significantly worse in the elderly patients than in the younger patients (P =0.013). Hypertension and respiratory disease were more common in the elderly patients than in the younger patients (P = 0.032/0.005). The findings for the following parameters were similar in the two groups : intraoperative blood loss, operation time, severe postoperative complication rate, time required to start a solid diet, and duration of postoperative hospital stay. The rate of major complications was not different between the two groups, although minor complications were more commonly observed in the elderly patients. Conclusion : TLDG was found to be a safe procedure for elderly patients. This method can be used as one of the standard treatments for gastric cancer in elderly patients.

Journal

  • 福岡医学雑誌 = Fukuoka acta medica

    福岡医学雑誌 = Fukuoka acta medica 104(9), 290-298, 2013-09-25

    福岡医学会

Codes

  • NII Article ID (NAID)
    120005372094
  • NII NACSIS-CAT ID (NCID)
    AN00215478
  • Text Lang
    ENG
  • Article Type
    journal article
  • Journal Type
    大学紀要
  • ISSN
    0016-254X
  • NDL Article ID
    025122831
  • NDL Call No.
    Z19-86
  • Data Source
    NDL  IR 
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