SURGICAL CASES OF GASTRIC CANCER IN PATIENTS OVER 80 YEARS OLD

Twenty-two elderly (over 80 years old) gastric cancer patients undergone operations were subjected to a review of the preoperative examination results, types of operation, complication rate, and hosptial mortality. Early gastric cancers of protruded type and advanced gastric cancers of Type Borrmann 3 in lower third (region A) were common. The resection rate was 95.5%; the curative resection rate, 55.6%; the complication rate, 45.5%; hospital mortality, 18.2%; and operative mortality, 4.5%. In the preoperative examinations, the highest incidence of abnormal data was shown at the lung (68.2%), followed by those at the liver and the heart. The pulmonary complications occupied 70% of the postoperative complications. In the group having four or more abnormal items in the preoperative examinations, the complication rate was 71.4%, and hospital mortality rate was 42.9%. There were no significant correlations between the resected area of R-number (extent of lymph node removal), and complication rate or hospital mortality. The five-year survival rate of curative resection cases was a favorable 77.8%. For enhancement of the operative result, the determination of an adequate region for resection and selective dissection of associated lymph nodes are both necessary, depending on the general status and local findings. Temporary gastrostomy with fine calibre tube, as well as forbiding smoking, chest physiotherapy, and tracheal cleaning, was beneficial to prevent pulmonary complications.