Laparoscopic gastrectomy for gastric cancer in the elderly

This review is conducted to determine the safety and efficacy of laparoscopic gastrectomy in elderly patients with gastric cancer. Studies published between March 1965 and August 2015 were systematically searched. Three types of study were included, including 1) studies comparing elderly patients versus younger patients undergoing laparoscopic gastrectomy for gastric cancer, 2) studies comparing laparoscopic gastrectomy versus open gastrectomy in elderly patients with gastric cancer, and 3) any case series of laparoscopic gastrectomy in elderly patients with gastric cancer. Twenty-six studies were included and composed of 24 comparative studies and 2 case series. When comparing elderly patients with younger patients undergoing laparoscopic gastrectomy, most comparative studies did not show significant difference in postoperative morbidity and mortality rate between the two groups, either the age threshold of the elderly was 70 or 75 years old. When comparing laparoscopic with open gastremtomy in the elderly, laparoscopic gastrectomy lead to a lower incidence of postoperative complications, a faster recovery of gastrointestinal function and a shorter hospital stay compared with open gastrectomy, with similar pathological and long-term oncological outcomes. Laparoscopic gastrectomy in elderly patients with gastric cancer is relatively safe and feasible at least when the age threshold of the elderly was 75 years old or less. Moreover, laparoscopic gastrectomy leads to less postoperative complications and faster postoperative recovery than open gastrectomy. More studies are needed to investigate the safety and efficacy of laparoscopic gastrectomy in the eldest elderly patient (aged >= 80 years old or more) in the future.