KẾT QUẢ PHẪU THUẬT CẮT DẠ DÀY BÁN PHẦN CỰC DƯỚI, NẠO VÉT HẠCH ĐIỀU TRỊ UNG THƯ BIỂU MÔ DẠ DÀY Ở NGƯỜI CAO TUỔI TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC GIAI ĐOẠN 2016 - 2020

Abstract

Objective: To evaluate the outcomes of laparoscopic versus open distal subtotal gastrectomy with lymphadenectomy for the treatment of gastric adenocarcinoma in elderly patients. Subjects and Methods: A retrospective descriptive study with longitudinal follow-up was conducted on 60 patients aged ≥60 years who underwent surgery at Viet Duc University Hospital between 2016 and 2020. Patients were assigned to either the laparoscopic group (n = 30) or the open surgery group (n = 30). Results: The two groups had comparable mean ages and tumor stage distributions. The mean operative time was significantly longer in the laparoscopic group (196.3 ± 32.1 minutes vs. 164.3 ± 27.8 minutes; p < 0.05). The mean number of retrieved lymph nodes did not differ significantly between groups (p = 0.32). Patients in the laparoscopic group had a shorter time to first flatus and shorter postoperative hospital stays (p < 0.05). Postoperative complications occurred predominantly in the open surgery group and included pneumonia, surgical site infection, gastrointestinal leakage, and duodenal stump rupture. The mean follow-up duration was 69,9 months (8 - 110 months). There was no statistically significant difference in overall survival (OS) or disease-free survival (DFS) between the two groups (p = 0.48 and p = 0.50, respectively). The 5-year overall survival rates were 75.5% for open surgery and 83.0% for laparoscopic surgery. Conclusion: Laparoscopic distal subtotal gastrectomy with lymph node dissection is a feasible and safe treatment option for elderly patients with gastric cancer, providing comparable oncologic outcomes to open surgery while offering advantages in postoperative recovery.