PURPOSE: The role of laparoscopic resection in management of rectal cancer is still controversial. The purpose of this study was to evaluate whether laparoscopic rectal resection for rectal cancer could be safely performed in elderly patients. METHODS:Forty-four elderly patients (> or =75 years) undergoinglaparoscopic rectal resection (group A) were compared with 228 younger patients (<75 years) undergoinglaparoscopic rectal resection (group B) and 43 elderly patients (> or =75 years) undergoingopen rectal resection (group C). RESULTS: The American Society of Anesthesiologists' status was significantly higher in group A than in group B. Operative procedure, operating time, and estimated blood loss were comparable, and overall postoperative complications did not differ significantly between groups A and B (13.6% vs. 11.8%). Operating time was longer (256 vs. 196 min), but estimated blood loss was significantly less (25 vs. 241 ml) in group A than in group C. The rate of postoperative complications was lower (13.6% vs. 25.6%) in group A than in group C, but the difference was not statistically significant. Time to flatus (1.3 vs. 3.7 days), time to liquid diet (2.2 vs. 7.0 days), and hospital stay (19 vs. 22 days) were significantly shorter in group A than in group C. CONCLUSIONS:Laparoscopic rectal resection for elderly patients can be safely performed with similar postoperative outcomes as in younger patients and may have advantages in terms of faster gastrointestinal recovery and shorter length of hospital stay compared with open surgery.
RCT Entities:
PURPOSE: The role of laparoscopic resection in management of rectal cancer is still controversial. The purpose of this study was to evaluate whether laparoscopic rectal resection for rectal cancer could be safely performed in elderly patients. METHODS: Forty-four elderly patients (> or =75 years) undergoing laparoscopic rectal resection (group A) were compared with 228 younger patients (<75 years) undergoing laparoscopic rectal resection (group B) and 43 elderly patients (> or =75 years) undergoing open rectal resection (group C). RESULTS: The American Society of Anesthesiologists' status was significantly higher in group A than in group B. Operative procedure, operating time, and estimated blood loss were comparable, and overall postoperative complications did not differ significantly between groups A and B (13.6% vs. 11.8%). Operating time was longer (256 vs. 196 min), but estimated blood loss was significantly less (25 vs. 241 ml) in group A than in group C. The rate of postoperative complications was lower (13.6% vs. 25.6%) in group A than in group C, but the difference was not statistically significant. Time to flatus (1.3 vs. 3.7 days), time to liquid diet (2.2 vs. 7.0 days), and hospital stay (19 vs. 22 days) were significantly shorter in group A than in group C. CONCLUSIONS: Laparoscopic rectal resection for elderly patients can be safely performed with similar postoperative outcomes as in younger patients and may have advantages in terms of faster gastrointestinal recovery and shorter length of hospital stay compared with open surgery.
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: Nikiforos Ballian; Natalie Weisensel; Victoria Rajamanickam; Eugene F Foley; Charles P Heise; Bruce A Harms; Gregory D Kennedy Journal: World J Surg Date: 2012-10 Impact factor: 3.352
Authors: Nicolas C Buchs; Pietro Addeo; Francesco M Bianco; Subhashini Ayloo; Enrique F Elli; Pier C Giulianotti Journal: J Robot Surg Date: 2010-05-26