The Effect of Old Age on the Development of Postoperative Complication in Surgery for Gastric Carcinoma

Shin, Dae Geun; Seong, Seung Hoon; Kim, Wan Sik; Kim, Dae Sung

Abstract

PURPOSE
Despite the fact that the number of elderly in the population has increased due to the improvement in medical skills and equipment and an increased interest in health, there is a view common among patients, guardians, and even the surgeons that the prognosis after surgery in the elderly is not optimistic. We examined the effect of old age on the prognosis after surgery in patients who were to undergo surgery after being diagnosed with gastric cancer. The effect of old age on the development of postoperative complications was evaluated. METHOD: Five hundred and seventy three patients, who underwent surgery for gastric cancer from January 1994 to December 1998 at Wonju Christian Hospital under Yonsei University Wonju College of Medicine, were analyzed retrospectively. The patients were divided into those older and younger 70 years of age. The presence of an underlying disease, the physical condition according to ASA(American Society of Anesthesiologist) classification, the extent of the resection, the TNM stage according to the AJCC (American Joint Committee on Cancer), and the operation time were examined. The effects of age on the postoperative complications in the study and control groups were also evaluated. RESULTS: Among the 573 patients, 515 were under 70 years and 58 were older than 70. Those older than 70 years, showed significant differences with physical condition (P<0.001), the presence of an underlying disease (P=0.043), M stage of TNM staging (P=0.001), hospital days (P<0.001), and operation time (P=0.026). CONCLUSION: Age itself did not correlate with the development of postoperative complications (P=0.193). The presence of an underlying disease affected the development of postoperative complications regardless of age or gender. Therefore, surgery can be performed safely when the patient's condition is evaluated thoroughly before surgery and the operation is carried out as scheduled.